Management of chronic orofacial pain: a survey of general dentists in german university hospitals

NARCIS (Netherlands)

Wirz, Stefan; Ellerkmann, Richard K.; Buecheler, Marcus; Putensen, Christian; Nadstawek, Joachim; Wartenberg, Hans-Christian

2010-01-01

AIM: This survey assessed procedures performed by general dentists in German university hospitals treating patients with chronic orofacial pain (COP). METHODS: A standardized questionnaire was sent to dentists at all 42 German universities. Doctors were asked to describe demographics, diagnoses,

[How do Turkish immigrants evaluate cultural sensitivity in a German tertiary hospital?].

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Giese, Arnd; Uyar, Müberra; Henning, Bernhard F; Uslucan, Haci H; Westhoff, Timm; Pagonas, Nikolaos

2015-01-01

Culturally adequate medical care is a goal in Germany, but quantitative data concerning inpatients is lacking. Inpatients of a German tertiary hospital: Turkish migrants (T) and Germans (G) were interviewed in their respective native language. 121 T and 121 G were interviewed. 97.5% of T were Muslims, 82.6% of G were Christians. 88.5% of T judged religion as "important" or "very important" (G: 35.8%). 50.8% of T saw their opportunity to pray in the hospital as "bad" or "very bad" (G: 0.9%). Keeping to Islamic dietary rules in the hospital was "difficult" or "very difficult" for 90% of T. For 79.0% of female T care by a same-sex staff was "important" or "very important" (female G: 36.3%, male T: 40.0%, male G: 7.7%). The presence of a same-sex person during examinations or treatments was "much" or "very much" appreciated by 69.7% of female T, if same-sex care was impossible (female G: 25.4%, male T: 28.9%, male G: 6.1%). A retrospective analysis revealed that 5.8% of all 8988 hospital admissions during the period of study recruitment were Turkish migrants. To meet the needs of Turkish migrants German hospitals should improve the opportunity for Muslims to pray. Additionally, the cooperation with local imams should be sought. Precise descriptions of food ingredients or an adapted menu could help T to deal with Muslim dietary commandments. A culturally sensitive hospital should take into account that female as well as male T prefer to be cared of by same-sex physicians and nurses. Georg Thieme Verlag Stuttgart.

[Instruments of management accounting in german hospitals - potentials for competitive advantage and status quo].

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Berens, W; Lachmann, M; Wömpener, A

2011-03-01

The aim of this study is to provide an analysis of the status quo for the usage of instruments of management accounting in German hospitals. 600 managing directors of German hospitals were asked to answer a questionnaire about the usage of management accounting instruments in their hospitals. We obtained 121 usable datasets, which are evaluated in this study. A significant increase in the usage of management accounting instruments can be observed over time. The respondents have an overall positive perception of the usage of these instruments. Cost accounting and information systems are among the most widely used instruments, while widely discussed concepts like the balanced scorecard or clinical pathways show surprisingly low usage rates. © Georg Thieme Verlag KG Stuttgart · New York.

[Patient endangerment due to device diversity? : Discussion of a risk factor based on the results of two surveys of German hospitals].

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Lange, K; Brinker, A; Nowak, M; Zöllner, C; Lauer, W

2018-05-25

The Federal Institute for Drugs and Medical Devices (BfArM) was notified of an event in which it was not possible to sufficiently ventilate a patient suffering a severe asthma attack. It turned out that the ventilation pressures used by the device for pressure-controlled ventilation were below the values set by the user, which the user was not aware of. The ventilation pressures chosen by the user exceeded the preset alarm limits of the ventilator. This pressure and alarm management significantly differed from that of other ventilators used in the hospital. This and similar incident reports suggest that safely operating medical devices for anesthesia and intensive care may be impaired when different models of a device are used within a hospital. If different models are used, more device information needs to be stored in memory. Existing knowledge on human memory suggests that the more individual memory items (e. g. different operating rules) are stored, the greater the risk of memory interference and hence of impaired retrieval, particularly if the different items are associated with overlapping retrieval cues. This is the case when different devices are used for a single functional purpose under identical or similar circumstances. Based on individual incident reports and theoretical knowledge on an association between device diversity and use problems, this study aimed to determine the organizational conditions regarding device diversity that prevail in German hospitals. Additionally, the anesthetists' perspectives and experiences in defined clinical settings were investigated. For selected groups of medical devices, the biomedical engineers of German hospitals were surveyed about the different makes used in their hospital. Additionally, questionnaires were sent to a department of anesthesiology of a large University Hospital to investigate the personal experiences of working with different makes and models of a device. Using devices by different

Nursing practice in the prevention of pressure ulcers: an observational study of German Hospitals.

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Hoviattalab, Khadijeh; Hashemizadeh, Haydeh; D'Cruz, Gibson; Halfens, Ruud J G; Dassen, Theo

2015-06-01

The study aimed to establish the range and extent of preventive interventions undertaken by nurses for patients who are at high risk of developing or currently have a pressure ulcer. Since 2000, the German National Expert Standard for the prevention of pressure ulcers has provided evidence-based recommendations, but limited studies have been published on its adherence in hospitals. There are also limited observational studies that investigated whether patients who are at risk of or have pressure ulcers are provided with appropriate preventative measures. A nonparticipant observational descriptive design was used. A sample of 32 adult patients who were at high risk of developing or currently had a pressure ulcer were observed during all shifts in medical and surgical wards in two general hospitals in Germany. A range of preventive interventions that were in line with the German National Expert Standard was observed. The most frequent preventive measures were 'cleaning the patients' skin' and 'minimizing exposure to moisture' that were undertaken in more than 90% of all patients. The least frequent measures were 'patient and relative education', 'assessment and recording of nutritional status'. This study demonstrates that the pressure ulcers preventive interventions as set out in the German National Expert Standard were not fully implemented. The study highlights the need for further studies on the barriers that impede the undertaking of the interventions that may prevent the development or deterioration of pressure ulcers and the delivery of evidence-based preventative care. This study provides an insight into the extent of pressure ulcers preventive practices used by nurses. The results may serve as a basis for developing an effective strategy to improve nursing practice in this area and the promotion of evidence-based practice. However, our results refer to two general hospitals and for a broader population, further studies with larger data samples are needed. �

Implementing 'self-help friendliness' in German hospitals: a longitudinal study.

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Trojan, Alf; Nickel, Stefan; Kofahl, Christopher

2016-06-01

In Germany, the term 'self-help friendliness' (SHF) describes a strategy to institutionalize co-operation of healthcare institutions with mutual aid or self-help groups of chronically ill patients. After a short explanation of the SHF concept and its development, we will present findings from a longitudinal study on the implementation of SHF in three German hospitals. Specifically, we wanted to know (i) to what degree SHF had been put into practice after the initial development phase in the pilot hospitals, (ii) whether it was possible to maintain the level of implementation of SHF in the course of at least 1 year and (iii) which opinions exist about the inclusion of SHF criteria in quality management systems. With only minor restrictions, the findings provide support for the usefulness, practicability, sustainability and transferability of SHF. Limitations of our empirical study are the small number of hospitals, the above average motivation of their staff, the small response rate in the staff-survey and the inability to get enough data from members of self-help groups. The research instrument for measuring SHF was adequate and fulfils the most important scientific quality criteria in a German context. We conclude that the implementation of SHF leads to more patient-centredness in healthcare institutions and thus improves satisfaction, self-management, coping and health literacy of patients. SHF is considered as an adequate approach for reorienting healthcare institutions in the sense of the Ottawa Charta, and particularly suitable for health promoting hospitals. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Experience and results of MELCOR application for German PWRs

International Nuclear Information System (INIS)

Sonnenkalb, M.

1999-01-01

An introduction into severe accident research work performed at GRS with regard to the use of the MELCOR code is given in Chapter One of the paper. Experience in applying MELCOR 1.8.3 for German PWRs and results of MELCOR calculations done within the project 'Accident management - Mitigation' for German LWRs are presented in Chapter Two. This 3-year project was finished February 1998. It was funded by the German Ministry for Environment, Nature Conservation and Nuclear Safety - BMU. In Chapter Three, a short overview of a training course on 'Phenomenology of Severe Accidents in PWR-Plants' is given. Mainly due to the interest from German NPPs GRS developed this special training session in 1996. Since 1996 it has been held several times for operators, shift personnel and the management board of two different German NPPs and for lecture of the German NPP training centre in Essen. In Chapter Four, results of the application of MELCOR 1.8.4 for German PWRs are presented. This work is done within a new project on 'Accident Management - Mitigation' for German LWRs. It was started in March 1998 and is again funded by the German Federal Ministry BMU. An objective of this project is to perform further MELCOR calculations, to be used within a PSA level 2 study for a German PWR, which is done at GRS in parallel. The experience of using MELCOR for German PWRs are summarised in Chapter Five. (author)

A cross-national comparison of incident reporting systems implemented in German and Swiss hospitals.

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Manser, Tanja; Imhof, Michael; Lessing, Constanze; Briner, Matthias

2017-06-01

This study aimed to empirically compare incident reporting systems (IRS) in two European countries and to explore the relationship of IRS characteristics with context factors such as hospital characteristics and characteristics of clinical risk management (CRM). We performed exploratory, secondary analyses of data on characteristics of IRS from nationwide surveys of CRM practices. The survey was originally sent to 2136 hospitals in Germany and Switzerland. Persons responsible for CRM in 622 hospitals completed the survey (response rate 29%). None. Differences between IRS in German and Swiss hospitals were assessed using Chi2, Fisher's Exact and Freeman-Halton-Tests, as appropriate. To explore interrelations between IRS characteristics and context factors (i.e. hospital and CRM characteristics) we computed Cramer's V. Comparing participating hospitals across countries, Swiss hospitals had implemented IRS earlier, more frequently and more often provided introductory IRS training systematically. German hospitals had more frequently systematically implemented standardized procedures for event analyses. IRS characteristics were significantly associated with hospital characteristics such as hospital type as well as with CRM characteristics such as existence of strategic CRM objectives and of a dedicated position for central CRM coordination. This study contributes to an improved understanding of differences in the way IRS are set up in two European countries and explores related context factors. This opens up new possibilities for empirically informed, strategic interventions to further improve dissemination of IRS and thus support hospitals in their efforts to move patient safety forward. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Human resource crises in German hospitals--an explorative study.

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Schermuly, Carsten C; Draheim, Michael; Glasberg, Ronald; Stantchev, Vladimir; Tamm, Gerrit; Hartmann, Michael; Hessel, Franz

2015-05-28

The complexity of providing medical care in a high-tech environment with a highly specialized, limited labour force makes hospitals more crisis-prone than other industries. An effective defence against crises is only possible if the organizational resilience and the capacity to handle crises become part of the hospitals' organizational culture. To become more resilient to crises, a raised awareness--especially in the area of human resource (HR)--is necessary. The aim of this paper is to contribute to the process robustness against crises through the identification and evaluation of relevant HR crises and their causations in hospitals. Qualitative and quantitative methods were combined to identify and evaluate crises in hospitals in the HR sector. A structured workshop with experts was conducted to identify HR crises and their descriptions, as well as causes and consequences for patients and hospitals. To evaluate the findings, an online survey was carried out to rate the occurrence (past, future) and dangerousness of each crisis. Six HR crises were identified in this study: staff shortages, acute loss of personnel following a pandemic, damage to reputation, insufficient communication during restructuring, bullying, and misuse of drugs. The highest occurrence probability in the future was seen in staff shortages, followed by acute loss of personnel following a pandemic. Staff shortages, damage to reputation, and acute loss of personnel following a pandemic were seen as the most dangerous crises. The study concludes that coping with HR crises in hospitals is existential for hospitals and requires increased awareness. The six HR crises identified occurred regularly in German hospitals in the past, and their occurrence probability for the future was rated as high.

German precursor study: methods and results

International Nuclear Information System (INIS)

Hoertner, H.; Frey, W.; von Linden, J.; Reichart, G.

1985-01-01

This study has been prepared by the GRS by contract of the Federal Minister of Interior. The purpose of the study is to show how the application of system-analytic tools and especially of probabilistic methods on the Licensee Event Reports (LERs) and on other operating experience can support a deeper understanding of the safety-related importance of the events reported in reactor operation, the identification of possible weak points, and further conclusions to be drawn from the events. Additionally, the study aimed at a comparison of its results for the severe core damage frequency with those of the German Risk Study as far as this is possible and useful. The German Precursor Study is a plant-specific study. The reference plant is Biblis NPP with its very similar Units A and B, whereby the latter was also the reference plant for the German Risk Study

Medical aspects of renewable energy shown by the example of German hospitals; Umweltmedizinische Gesichtspunkte der regenerativen Energieerzeugung am Beispiel deutscher Krankenhaeuser

Energy Technology Data Exchange (ETDEWEB)

Waschnewski, R.

2007-07-01

To what extend are renewable energy sources used in German hospitals? This is the main objective, this is paper is dealing with. The energy consumption profile is very specific in hospitals. In a questionnaire based study, 79 hospitals have been questioned to elucidate the current situation in German hospitals with respect to energy consumption, and to get an idea of the proportion of alternative energy sources already in use. Our analysis reveals that 14% of the hospitals analysed are already using renewable energy sources. Main sources already utilized are photovoltaic, solar thermal devices, and to a lower extend geothermic energy as well comes into operation. Almost three quarters of the questioned institutions claim, they are aware of funding possibilities and the option of contracting with respect to providing financial support in relation to aquisition of new establishments of alternative energy systems within their institution. Roughly half of the hospital's technical supervisors are aware of the precise energy potential of their institution. The situation about information and awareness with respect to possibilities related to the usage of green energy is deficient and should be improved, but the openness with respect to the topic in general seems to be very positive and advantage of that climate should be taken. Our survey allowed to get an initial estimate on the green energy situation in German hospitals. The focus of the discussion is channeled towards the environmental aspects of the energy production. The survey data allow to conclude that the current information situation is deficient. The data further provide insight into what are the main barriers with respect to the use of renewable energy. Based on our results future analyses can not focus on specific aspects and further evaluate approaches allowing to extend the usage of alternative energy sources in hospitals. (orig.)

Evaluation of psychometric properties of the German Hospital Survey on Patient Safety Culture and its potential for cross-cultural comparisons: a cross-sectional study.

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Gambashidze, Nikoloz; Hammer, Antje; Brösterhaus, Mareen; Manser, Tanja

2017-11-09

To study the psychometric characteristics of German version of the Hospital Survey on Patient Safety Culture and to compare its dimensionality to other language versions in order to understand the instrument's potential for cross-national studies. Cross-sectional multicentre study to establish psychometric properties of German version of the survey instrument. 73 units from 37 departments of two German university hospitals. Clinical personnel (n=995 responses, response rate 39.6%). Psychometric properties (eg, model fit, internal consistency, construct validity) of the instrument and comparison of dimensionality across different language translations. The instrument demonstrated acceptable to good internal consistency (Cronbach's alpha 0.64-0.88). Confirmatory factor analysis of the original 12-factor model resulted in marginally satisfactory model fit (root mean square error of approximation (RMSEA)=0.05; standardised root mean residual (SRMR)=0.05; comparative fit index (CFI)=0.90; goodness of fit index (GFI)=0.88; Tucker-Lewis Index (TLI)=0.88). Exploratory factor analysis resulted in an alternative eight-factor model with good model fit (RMSEA=0.05; SRMR=0.05; CFI=0.95; GFI=0.91; TLI=0.94) and good internal consistency (Cronbach's alpha 0.73-0.87) and construct validity. Analysis of the dimensionality compared with models from 10 other language versions revealed eight dimensions with relatively stable composition and appearance across different versions and four dimensions requiring further improvement. The German version of Hospital Survey on Patient Safety Culture demonstrated satisfactory psychometric properties for use in German hospitals. However, our comparison of instrument dimensionality across different language versions indicates limitations concerning cross-national studies. Results of this study can be considered in interpreting findings across national contexts, in further refinement of the instrument for cross-national studies and in better

Discrimination in waiting times by insurance type and financial soundness of German acute care hospitals.

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Schwierz, Christoph; Wübker, Achim; Wübker, Ansgar; Kuchinke, Björn A

2011-10-01

This paper shows that patients with private health insurance (PHI) are being offered significantly shorter waiting times than patients with statutory health insurance (SHI) in German acute hospital care. This behavior may be driven by the higher expected profitability of PHI relative to SHI holders. Further, we find that hospitals offering private insurees shorter waiting times when compared with SHI holders have a significantly better financial performance than those abstaining from or with less discrimination.

Antibiotics susceptibility patterns of bacteria isolated from American and German cockroaches as potential vectors of microbial pathogens in hospitals

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Mohammad Reza Fakoorziba

2014-09-01

Full Text Available Objective: To identify the cockroach species, their bacterial flora and antibiotics susceptibility patterns of these bacteria in Shiraz. Methods: In the present descriptive study, only two species of cockroaches were recognized. The washing solutions from the digestion systems and surfaces of 156 American and German cockroaches were cultured. The latter was found to be the commonest (89.7% in all places. Results: Overall, 18 species of bacteria were isolated and identified by standard culture methods. The most frequent bacterium isolated from both species of cockroaches in all places was Pseudomonas (41.7%. The second and third commonest bacteria were Enterobacter (39.7% and Klebsiella (32.7%, respectively. Conclusions: The antibiogram profiles showed full (100% resistance of Klebsiella, Citrobacter, Acinetobacter and Proteus to amoxicillin and ampicillin at both hospitals, while Pseudomonas showed resistance (95.7% to cephalothin. Thus it is concluded that German and American cockroaches carry multidrug resistant bacteria in two hospitals which raises alarm for stricter control measures.

[Subjective job strain and job satisfaction among neurologists in German hospitals].

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Bauer, J; Bendels, M H K; Groneberg, D A

2016-06-01

The number of sick leaves due to job strain is increasing. This study's scope is to examine working conditions of neurologists in hospitals in regard to job strain and job satisfaction. This study is part of the iCEPT-Study. The iCEPT-Study was conducted as a web based survey among physicians (n = 7090) in German hospitals. The focus was on working conditions regarding job strain. Job strain was measured by a questionnaire consisting of items and scales from the short version of the Effort-Reward-Imbalance (ERI) questionnaire and the short questionnaire for working analysis (KFZA). By calculation ratios of distinct scales according to validated stress models a conclusion could be drawn as to whether or not job strain was present. The total number of n = 354 neurologists were analyzed. The response rate was at 18.2 %. Job strain was encountered by 52.0 % (95 %-KI: 46.7|57.2) of all neurologists and no significant gender difference was present. However, resident neurologists were significantly more often exposed to job strain than attending neurologists (OR = 2.9; 95 %-KI: 1.6-4.7; p job satisfaction, 59.6 % (95 %-KI: 54.5-64.7) of all respondents stated to be satisfied with their job. Significantly more men were satisfied than women (OR = 1.5; 95 %-KI: 1.0-2.4; p job than residents (OR = 2.9; 95 %-KI: 1.7-4.8; p job strain among neurologists in German hospitals. Keeping the negative implications of mental and physical health in mind, the working conditions of neurologists must be improved. As shown in this study, a possible way to do so is to increase job control in order to decrease a major stressor at work.

Assessing the safety attitudes questionnaire (SAQ), German language version in Swiss university hospitals - a validation study

Science.gov (United States)

2013-01-01

Background Improving patient safety has become a major focus of clinical care and research over the past two decades. An institution’s patient safety climate represents an essential component of ensuring a safe environment and thereby can be vital to the prevention of adverse events. Covering six patient safety related factors, the Safety Attitudes Questionnaire (SAQ) is a validated and widely used instrument to measure the patient safety climate in clinical areas. The objective of this study was to assess the psychometric properties of the German language version of the SAQ. Methods A survey was carried out in two University Hospitals in Switzerland in autumn 2009 where the SAQ was distributed to a sample of 406 nurses and physicians in medical and surgical wards. Following the American Educational Research Association guidelines, we tested the questionnaire validity by levels of evidence: content validity, internal structure and relations to other variables. Confirmatory factor analysis was used to examine factor structure. Cronbach’s alphas and inter-item correlations were calculated to examine internal consistency reliability. Results A total of 319 questionnaires were completed representing an overall response rate of 78.6%. For three items, the item content validity index was <0.75. Confirmatory factor analysis showed acceptable model fit (RMSEA = 0.045; CFI = 0.944) for the six-factor model. Additional exploratory factor analysis could not identify a better factor model. SAQ factor scores showed positive correlations with the Safety Organizing Scale (r = .56 - .72). The SAQ German version showed moderate to strong internal consistency reliability indices (Cronbach alpha = .65 - .83). Conclusions The German language version of the SAQ demonstrated acceptable to good psychometric properties and therefore shows promise to be a sound instrument to measure patient safety climate in Swiss hospital wards. However, the low item content validity and large number

Basic aspects and results of the German risk study

International Nuclear Information System (INIS)

Bayer, A.; Heuser, F.W.

1981-01-01

This article presents an overview of the investigations and results of the German Risk Study (Phase A). Similar to its American counterpart [Reactor Safety Study (WASH-1400)], the German Risk Study assesses the societal risks associated with potential accidents in nuclear power plants sited in the Federal Republic of Germany. The technical part of the analysis was performed for a representative pressurized-water-reactor nuclear power plant of the 1300-MW(e) class. For the risk assessment, 19 sites were considered, with a total of 25 reactor units presently in operation, under construction, or undergoing the licensing procedure. In the spring of 1981 a translation of the main report [German Risk Study-Main Report (EPRI-NP-1804-SR)], including the investigations and results of Phase A, was published by the Electric Power Research Institute

[Cases and duration of mechanical ventilation in German hospitals : An analysis of DRG incentives and developments in respiratory medicine].

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Biermann, A; Geissler, A

2016-09-01

Diagnosis-related groups (DRGs) have been used to reimburse hospitals services in Germany since 2003/04. Like any other reimbursement system, DRGs offer specific incentives for hospitals that may lead to unintended consequences for patients. In the German context, specific procedures and their documentation are suspected to be primarily performed to increase hospital revenues. Mechanical ventilation of patients and particularly the duration of ventilation, which is an important variable for the DRG-classification, are often discussed to be among these procedures. The aim of this study was to examine incentives created by the German DRG-based payment system with regard to mechanical ventilation and to identify factors that explain the considerable increase of mechanically ventilated patients in recent years. Moreover, the assumption that hospitals perform mechanical ventilation in order to gain economic benefits was examined. In order to gain insights on the development of the number of mechanically ventilated patients, patient-level data provided by the German Federal Statistical Office and the German Institute for the Hospital Remuneration System were analyzed. The type of performed ventilation, the total number of ventilation hours, the age distribution, mortality and the DRG distribution for mechanical ventilation were calculated, using methods of descriptive and inferential statistics. Furthermore, changes in DRG-definitions and changes in respiratory medicine were compared for the years 2005-2012. Since the introduction of the DRG-based payment system in Germany, the hours of ventilation and the number of mechanically ventilated patients have substantially increased, while mortality has decreased. During the same period there has been a switch to less invasive ventilation methods. The age distribution has shifted to higher age-groups. A ventilation duration determined by DRG definitions could not be found. Due to advances in respiratory medicine, new

Assessing the Safety Attitudes Questionnaire (SAQ), German language version in Swiss university hospitals--a validation study.

Science.gov (United States)

Zimmermann, Natalie; Küng, Kaspar; Sereika, Susan M; Engberg, Sandra; Sexton, Bryan; Schwendimann, René

2013-09-10

Improving patient safety has become a major focus of clinical care and research over the past two decades. An institution's patient safety climate represents an essential component of ensuring a safe environment and thereby can be vital to the prevention of adverse events. Covering six patient safety related factors, the Safety Attitudes Questionnaire (SAQ) is a validated and widely used instrument to measure the patient safety climate in clinical areas. The objective of this study was to assess the psychometric properties of the German language version of the SAQ. A survey was carried out in two University Hospitals in Switzerland in autumn 2009 where the SAQ was distributed to a sample of 406 nurses and physicians in medical and surgical wards. Following the American Educational Research Association guidelines, we tested the questionnaire validity by levels of evidence: content validity, internal structure and relations to other variables. Confirmatory factor analysis was used to examine factor structure. Cronbach's alphas and inter-item correlations were calculated to examine internal consistency reliability. A total of 319 questionnaires were completed representing an overall response rate of 78.6%. For three items, the item content validity index was <0.75. Confirmatory factor analysis showed acceptable model fit (RMSEA = 0.045; CFI = 0.944) for the six-factor model. Additional exploratory factor analysis could not identify a better factor model. SAQ factor scores showed positive correlations with the Safety Organizing Scale (r = .56-.72). The SAQ German version showed moderate to strong internal consistency reliability indices (Cronbach alpha = .65-.83). The German language version of the SAQ demonstrated acceptable to good psychometric properties and therefore shows promise to be a sound instrument to measure patient safety climate in Swiss hospital wards. However, the low item content validity and large number of missing responses for several items suggest

[Evaluating the effectiveness of a disease management program diabetes in the German Statutory Health Insurance: first results and methodological considerations].

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Drabik, Anna; Graf, Christian; Büscher, Guido; Stock, Stephanie

2012-01-01

Disease management programs (DMPs) were implemented in the German Statutory Health Insurance (SHI) in a nationwide rollout in 2002. The explicit goal of the programs is to improve coordination and quality of care for the chronically ill (Sect. 137f, SGB V). To reach this goal extensive quality assurance measures in the programs are mandatory, enrolment and coordination of care rests with the primary care or DMP physician, treatment is based on evidence-based care guidelines, and patients are offered diabetes education classes to support self-management. The present study evaluates the DMP diabetes mellitus type II, a nationwide program offered by the BARMER, a German health insurance company. To minimize selection bias we formed a control group of administrative data using a propensity score matching approach. In comparison to the control group DMP participants have a significantly lower mortality rate, and their average drug and hospital costs are reduced. Enrolled patients also had a lower mean number of hospital stays and shorter hospital stays. These results indicate that the programs meet the initial goal of improving the quality of care for the chronically ill. Copyright © 2011. Published by Elsevier GmbH.

Medical Aid, Repression, and International Relations: The East German Hospital at Metema.

Science.gov (United States)

Borowy, Iris

2016-01-01

Between 1984 and 1988, the German Democratic Republic (GDR) built a hospital in a remote part of Ethiopia, close to the Sudanese border. The project evolved in a complex combination of contexts, including the general foreign policy goals of the GDR, its specific alliance with Ethiopia, the famine of 1984-85, civil war in Ethiopia, and a controversial resettlement program by the government of Mengistu Haile Mariam. Though almost unknown today, it was a high-profile project at the time, which received the personal support both by Erich Honecker in the GDR and Mengistu Haile Mariam in Ethiopia. However, their interest was directed more at the political goals the project was expected to serve than at the hospital itself. Both the preparation and the implementation of the project were extremely difficult and almost failed due to problems of transportation, of red tape, and of security. The operation of the hospital was also not ideal, involving frustrated personnel and less than complete acceptance by the local population. Ironically, for all its practical difficulties, the hospital has outlived both governments and their political goals, surviving as a medical institution. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

HOW COULD HOSPITALS ACT IN AN AGEING SOCIETY?

Directory of Open Access Journals (Sweden)

Leuca Mirela

2011-12-01

Full Text Available The demographic changes are of great importance for all European societies. Their impact and effects have multiple, deep facets. Each European healthcare and welfare system will be facing considerable changes in the new demographic context. The hospital sector plays an important role in each health system. This paper focuses on the impact of the demographic changes on hospitals, presents and analyzes statistical data for the German hospitals sector in order to underline the importance of the older age groups for the number of the hospital inpatient cases, the provided range of medical services and disciplines and for the hospital disease costs. The paper also reveals main findings from 30 interviews conducted in 2010 with German health experts (from hospitals, health insurance companies, universities, institutes and regional healthcare policy makers that accepted to answer questions referring to the demographic impact on the German healthcare system and hospital sector. The results of the interviews show that hospitals will have to act and react to the demographic changes. German hospitals might play different roles in the healthcare service provision for older people when engaging in new models of integrated care that will have to be developed. Processes, structures, human resources expertise, hospital service provision and medical departments will undergo major changes in response to the demographic challenges. Networks, centres of excellence for older persons and integrated care will probably be indispensable structures of the German healthcare system in the future. Strategic partnerships with pre- and post-hospital healthcare service providers are considered to be top priorities for German hospitals when facing the demographic challenge. Central case management and process optimization can be essential factors of success in the hospital care of the older, multimorbid patients. Acute geriatric medicine will be a main quality feature for the

German risk study, phase B: Results of the event tree and fault tree analysis

International Nuclear Information System (INIS)

Hoertner, H.

1987-01-01

This paper deals with the most important results of the level 1 analysis performed in Phase B of the German Risk Study and with the insights it provided. The question is raised, to what extent the results of risk analyses can be verified against available operating experience. In this respect the results of the German Risk Study will be compared with the estimates of the German Precursor Study. Finally, the results of the German investigations are briefly compared with the results of recent U.S. risk analyses. (orig.)

Is Whole-Body Computed Tomography the Standard Work-up for Severely-Injured Children? Results of a Survey among German Trauma Centers.

Science.gov (United States)

Bayer, J; Reising, K; Kuminack, K; Südkamp, N P; Strohm, P C

2015-01-01

Whole-body computed tomography is accepted as the standard procedure in the primary diagnostic of polytraumatised adults in the emergency room. Up to now there is still controversial discussion about the same algorithm in the primary diagnostic of children. The aim of this study was to survey the participation of German trauma-centres in the care of polytraumatised children and the hospital dependant use of whole-body computed tomography for initial patient work-up. A questionnaire was mailed to every Department of Traumatology registered in the DGU (German Trauma Society) databank. We received 60,32% of the initially sent questionnaires and after applying exclusion criteria 269 (53,91%) were applicable to statistical analysis. In the three-tiered German hospital system no statistical difference was seen in the general participation of children polytrauma care between hospitals of different tiers (p = 0.315). Even at the lowest hospital level 69,47% of hospitals stated to participate in polytrauma care for children, at the intermediate and highest level hospitals 91,89% and 95,24% stated to be involved in children polytrauma care, respectively. Children suspicious of multiple injuries or polytrauma received significantly fewer primary whole-body CTs in lowest level compared to intermediate level hospitals (36,07% vs. 56,57%; p = 0.015) and lowest level compared to highest level hospitals (36,07% vs. 68,42%; p = 0.001). Comparing the use of whole-body CT in intermediate to highest level hospitals a not significant increase in its use could be seen in highest level hospitals (56,57% vs. 68,42%; p = 0.174). According to our survey, taking care of polytraumatised children in Germany is not limited to specialised hospitals or a defined hospital level-of-care. Additionally, there is no established radiologic standard in work-up of the polytraumatised child. However, in higher hospital care -levels a higher percentage of hospitals employs whole-body CTs for primary

Profiling quality of care for patients with chronic headache in three different German hospitals – a case study

Directory of Open Access Journals (Sweden)

Hager Stefan

2008-01-01

Full Text Available Abstract Background Legal requirements for quality assurance in German rehabilitation hospitals include comparisons of providers. Objective is to describe and to compare outcome quality of care offered by three hospitals providing in-patient rehabilitative treatment exemplified for patients with chronic headache. Methods We performed a prospective three center observational study on patients suffering from chronic headache. Patients underwent interventions commonly used according to internal guidelines of the hospitals. Measurements were taken at three points in time (at admission, at discharge and 6 months after discharge. Indicators of outcome quality included pain intensity and frequency of pain, functional ability, depression, quality of life and health related behavior. Analyses of differences amongst the hospitals were adjusted by covariates due to case-mix situation. Results 306 patients from 3 hospitals were included in statistical analysis. Amongst the hospitals, patients differed significantly in age, education, diagnostic subgroups, beliefs, and with respect to some pain-related baseline values (covariates. Patients in all three hospitals benefited from intervention to a clinically relevant degree. At discharge from hospital, outcome quality differed significantly after adjustment according to case-mix only in terms of patients' global assessment of treatment results. Six months after discharge, the only detectable significant differences were for secondary outcomes like improved coping with stress or increased use of self-help. The profiles for satisfaction with the hospital stay showed clear differences amongst patients. Conclusion The results of this case study do not suggest a definite overall ranking of the three hospitals that were compared, but outcome profiles offer a multilayer platform of reliable information which might facilitate decision making.

The relationship between hospital specialization and hospital efficiency: do different measures of specialization lead to different results?

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Lindlbauer, Ivonne; Schreyögg, Jonas

2014-12-01

This study investigated the relationship between hospital specialization and technical efficiency using different measures of specialization, including two novel approaches based on patient volumes rather than patient proportions. It was motivated by the observation that most studies to date have quantified hospital specialization using information about hospital patients grouped into different categories based on their diagnosis, and in doing so have used proportions-thus indirectly assuming that these categories are dependent on one other. In order to account for the diversification of organizations and the idea that hospitals can be specialized in terms of professional expertise or technical equipment within a given diagnosis category, we developed our two specialization measures based on patient volume in each category. Using a one-step stochastic frontier approach on randomly selected data from the annual reports of 1,239 acute care German hospitals for the years 2000 through 2010, we estimated the relationship of inefficiency to exogenous variables, such as specialization. The results show that specialization as quantified by our novel measures has effects on efficiency that are the opposite of those obtained using earlier measures of specialization. These results underscore the importance of always providing an exact definition of specialization when studying its effects. Additionally, a Monte Carlo simulation based on three scenarios is provided to facilitate the choice of a specialization measure for further analysis.

Strategies to enhance rational use of antibiotics in hospital : a guideline by the German Society for Infectious Diseases

NARCIS (Netherlands)

de With, K.; Allerberger, F.; Amann, S.; Apfalter, P.; Brodt, H. -R.; Eckmanns, T.; Fellhauer, M.; Geiss, H. K.; Janata, O.; Krause, R.; Lemmen, S.; Meyer, E.; Mittermayer, H.; Porsche, U.; Presterl, E.; Reuter, S.; Sinha, B.; Strauss, R.; Wechsler-Foerdoes, A.; Wenisch, C.; Kern, W. V.

In the time of increasing resistance and paucity of new drug development there is a growing need for strategies to enhance rational use of antibiotics in German and Austrian hospitals. An evidence-based guideline on recommendations for implementation of antibiotic stewardship (ABS) programmes was

Basic principles and results of the German risk study

International Nuclear Information System (INIS)

Heuser, F.W.; Bayer, A.

1980-01-01

In June 1976 the Federal Ministry for Research and Technology had commissioned the Gesellschaft fuer Reaktorsicherheit to write the German Risk Study, the first part of which has now been completed after three years of work and has been publicized recently. The German Risk Study is an attempt to define the societal risk posed by accidents in nuclear power plants under conditions in Germany. For this purpose, the accident rates and the resultant health hazards were determined. By adopting most of the basic premises and methods of the American Rasmussen Study, the German study is to allow a comparison to be made with the results of that study. The calculations were based on 19 sites with a total of 25 nuclear generating units presently in operation, under construction or in the licensing procedure in the Federal Republic of Germany. The technical studies were conducted on a 1300 MW PWR as the representative example. The results show that the decisive contributions are made by uncontrolled minor loss-of-coolant accidents and by failures of power supply (emergency power case). Large loss-of-coolant accidents do not play a role. The study also shows the decisive safety function of the containment. (orig.) [de

NATO mission in Kosovo: historical backgrounds and informations of working as radiologist in the German field hospital

International Nuclear Information System (INIS)

Voelk, M.; Danz, B.

2005-01-01

The first part of this article describes how the NATO mission in Kosovo came into existence and focuses on the historical background and ethnical problems. The second part deals with the working conditions of a radiologist in the German field hospital in Prizren and focuses on the personnel and technical equipment in the radiological department. (orig.) [de

The impact of a proactive chronic care management program on hospital admission rates in a German health insurance society.

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Hamar, Brent; Wells, Aaron; Gandy, William; Haaf, Andreas; Coberley, Carter; Pope, James E; Rula, Elizabeth Y

2010-12-01

Hospital admissions are the source of significant health care expenses, although a large proportion of these admissions can be avoided through proper management of chronic disease. In the present study, we evaluate the impact of a proactive chronic care management program for members of a German insurance society who suffer from chronic disease. Specifically, we tested the impact of nurse-delivered care calls on hospital admission rates. Study participants were insured individuals with coronary artery disease, heart failure, diabetes, or chronic obstructive pulmonary disease who consented to participate in the chronic care management program. Intervention (n  = 17,319) and Comparison (n  = 5668) groups were defined based on records of participating (or not participating) in telephonic interactions. Changes in admission rates were calculated from the year prior to (Base) and year after program commencement. Comparative analyses were adjusted for age, sex, region of residence, and disease severity (stratification of 3 [least severe] to 1 [most severe]). Overall, the admission rate in the Intervention group decreased by 6.2% compared with a 14.9% increase in the Comparison group (P  management care calls can help reduce hospital admissions among German health insurance members with chronic disease.

[Acute pain therapy in German hospitals as competitive factor. Do competition, ownership and case severity influence the practice of acute pain therapy?].

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Erlenwein, J; Hinz, J; Meißner, W; Stamer, U; Bauer, M; Petzke, F

2015-07-01

Due to the implementation of the diagnosis-related groups (DRG) system, the competitive pressure on German hospitals increased. In this context it has been shown that acute pain management offers economic benefits for hospitals. The aim of this study was to analyze the impact of the competitive situation, the ownership and the economic resources required on structures and processes for acute pain management. A standardized questionnaire on structures and processes of acute pain management was mailed to the 885 directors of German departments of anesthesiology listed as members of the German Society of Anesthesiology and Intensive Care Medicine (DGAI, Deutsche Gesellschaft für Anästhesiologie und Intensivmedizin). For most hospitals a strong regional competition existed; however, this parameter affected neither the implementation of structures nor the recommended treatment processes for pain therapy. In contrast, a clear preference for hospitals in private ownership to use the benchmarking tool QUIPS (quality improvement in postoperative pain therapy) was found. These hospitals also presented information on coping with the management of pain in the corporate clinic mission statement more often and published information about the quality of acute pain management in the quality reports more frequently. No differences were found between hospitals with different forms of ownership in the implementation of acute pain services, quality circles, expert standard pain management and the implementation of recommended processes. Hospitals with a higher case mix index (CMI) had a certified acute pain management more often. The corporate mission statement of these hospitals also contained information on how to cope with pain, presentation of the quality of pain management in the quality report, implementation of quality circles and the implementation of the expert standard pain management more frequently. There were no differences in the frequency of using the benchmarking

Factors Influencing Enrollment in Public High School German Courses: Results of a National Survey.

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Minert, Roger P.

1992-01-01

Questions regarding reasons students select or decline to study German are examined, based on the results of a survey conducted among students of German in 127 U.S. high schools. Student responses are discussed in the light of academic, demographic, social, and familial considerations, and a profile of the 1990s student of German is constructed.…

A risk-model for hospital mortality among patients with severe sepsis or septic shock based on German national administrative claims data.

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Schwarzkopf, Daniel; Fleischmann-Struzek, Carolin; Rüddel, Hendrik; Reinhart, Konrad; Thomas-Rüddel, Daniel O

2018-01-01

Sepsis is a major cause of preventable deaths in hospitals. Feasible and valid methods for comparing quality of sepsis care between hospitals are needed. The aim of this study was to develop a risk-adjustment model suitable for comparing sepsis-related mortality between German hospitals. We developed a risk-model using national German claims data. Since these data are available with a time-lag of 1.5 years only, the stability of the model across time was investigated. The model was derived from inpatient cases with severe sepsis or septic shock treated in 2013 using logistic regression with backward selection and generalized estimating equations to correct for clustering. It was validated among cases treated in 2015. Finally, the model development was repeated in 2015. To investigate secular changes, the risk-adjusted trajectory of mortality across the years 2010-2015 was analyzed. The 2013 deviation sample consisted of 113,750 cases; the 2015 validation sample consisted of 134,851 cases. The model developed in 2013 showed good validity regarding discrimination (AUC = 0.74), calibration (observed mortality in 1st and 10th risk-decile: 11%-78%), and fit (R2 = 0.16). Validity remained stable when the model was applied to 2015 (AUC = 0.74, 1st and 10th risk-decile: 10%-77%, R2 = 0.17). There was no indication of overfitting of the model. The final model developed in year 2015 contained 40 risk-factors. Between 2010 and 2015 hospital mortality in sepsis decreased from 48% to 42%. Adjusted for risk-factors the trajectory of decrease was still significant. The risk-model shows good predictive validity and stability across time. The model is suitable to be used as an external algorithm for comparing risk-adjusted sepsis mortality among German hospitals or regions based on administrative claims data, but secular changes need to be taken into account when interpreting risk-adjusted mortality.

Difficulties experienced by migrant physicians working in German hospitals: a qualitative interview study.

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Klingler, Corinna; Marckmann, Georg

2016-09-23

With Germany facing a shortage of doctors, hospitals have been increasingly recruiting physicians from abroad. Studies in other countries have shown that migrant physicians experience various difficulties in their work, which might impact the quality of patient care, physician job satisfaction, and, accordingly, retention. The experiences of migrant doctors in Germany have not been systematically studied so far and will likely differ from experiences migrant physicians make in other contexts. A thorough understanding of challenges faced by this group, however, is needed to develop adequate support structures-as required by the WHO Global Code of Practice on the International Recruitment of Health Personnel. A qualitative study was conducted to give an overview of the multifaceted difficulties migrant physicians might face in German hospitals. Twenty semi-structured interviews with foreign-born and foreign-trained physicians were conducted in German. Participants were recruited via the State Chambers of Physicians and snowballing based on a maximum variation sampling strategy varying purposefully by source country and medical specialty. The interviews were recorded, transcribed verbatim, and analysed using qualitative content analysis. Participants described difficulties relating to healthcare institutions, own competencies, and interpersonal interactions. Participants experienced certain legal norms, the regulation of licensure and application for work, and the organization of the hospital environment as inadequate. Most struggled with their lack of setting-specific (language, cultural, clinical, and system) knowledge. Furthermore, behaviour of patients and co-workers was perceived as discriminating or inadequate for other reasons. This is the first study to describe the broad range of issues migrant physicians experience in Germany. Based on this information, institutional actors should devise support structures to ensure quality of care, physician wellbeing, and

The German hospital malnutrition study.

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Pirlich, Matthias; Schütz, Tatjana; Norman, Kristina; Gastell, Sylvia; Lübke, Heinrich Josef; Bischoff, Stephan C; Bolder, Ulrich; Frieling, Thomas; Güldenzoph, Helge; Hahn, Kristian; Jauch, Karl-Walter; Schindler, Karin; Stein, Jürgen; Volkert, Dorothee; Weimann, Arved; Werner, Hansjörg; Wolf, Christiane; Zürcher, Gudrun; Bauer, Peter; Lochs, Herbert

2006-08-01

Malnutrition is frequently observed in chronic and severe diseases and associated with impaired outcome. In Germany general data on prevalence and impact of hospital malnutrition are missing. Nutritional state was assessed by subjective global assessment (SGA) and by anthropometric measurements in 1,886 consecutively admitted patients in 13 hospitals (n=1,073, university hospitals; n=813, community or teaching hospitals). Risk factors for malnutrition and the impact of nutritional status on length of hospital stay were analyzed. Malnutrition was diagnosed in 27.4% of patients according to SGA. A low arm muscle area and arm fat area were observed in 11.3% and 17.1%, respectively. Forty-three % of patients 70 years old were malnourished compared to only 7.8% of patients malnutrition was observed in geriatric (56.2%), oncology (37.6%), and gastroenterology (32.6%) departments. Multivariate analysis revealed three independent risk factors: higher age, polypharmacy, and malignant disease (all PMalnutrition was associated with an 43% increase of hospital stay (PMalnutrition is associated with increased length of hospital stay. Higher age, malignant disease and major comorbidity were found to be the main contributors to malnutrition. Adequate nutritional support should be initiated in order to optimize the clinical outcome of these patients.

Reduction of the nosocomial meticillin-resistant Staphylococcus aureus incidence density by a region-wide search and follow-strategy in forty German hospitals of the EUREGIO, 2009 to 2011

NARCIS (Netherlands)

Jurke, A; Kock, R; Becker, K; Thole, S; Hendrix, R; Rossen, J; Daniels-Haardt, I; Friedrich, AW

2013-01-01

Meticillin-resistant Staphylococcus aureus (MRSA) disseminates between hospitals serving one patient catchment area. Successful prevention and control requires concerted efforts and regional surveillance. Forty hospitals located in the German EUREGIO have established a network for combating MRSA. In

Shopping in Hospitality: Situational Constructions of Customer-Vendor Relationships among Shopping Tourists at a Bazaar on the German-Polish Border

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Busch, Dominic

2010-01-01

This article presents an analysis of a short customer-vendor dialogue between a German couple and a Polish vendor at a food bazaar on the Polish border with Germany. In this situation, interactants have to negotiate and construct framings of hospitality abroad, customer-vendor relations, as well as intercultural relations. It is assumed that…

Main results of the German nuclear power plant risk study

International Nuclear Information System (INIS)

Danzmann, H.J.

1981-01-01

The subject is discussed under the headings: introduction; purpose and task of the German risk study; approach; results of investigations (analyses of engineered plant features; determination of accident consequences); emergency response model; protective actions and countermeasures; evaluation. (U.K.)

Consumer attitudes about health care acquired infections: a German survey on factors considered important in the choice of a hospital.

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Vonberg, Ralf-Peter; Sander, Carsten; Gastmeier, Petra

2008-01-01

Most patients are free in their choice of hospital for nonemergency admissions. In a nationwide survey in 1000 German households, we interviewed randomly chosen persons (age 14 and older) by phone about what they consider important when choosing a hospital. A standardized questionnaire was used. Additionally, question order was randomized prior to each interview. Demographic data included age, gender, education, and previous admissions to hospitals. Categories that might influence the choice of hospital included "distance to hospital," "friendly staff," "staff-to-patient ratio," "cleanliness," "nosocomial infection rate," "own experiences," "friend's opinion," and "facility's reputation in public media." General cleanliness, low nosocomial infection rates, and friendly staff proved to be the most important issues in our study. In contrast, the reputation of the health care facility in the public media was much less important. It seems that kindness and basic hygiene measures, both quite inexpensive factors, are key issues for patients.

Job satisfaction and the work situation of physicians: a survey at a German university hospital.

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Laubach, Wilfried; Fischbeck, Sabine

2007-01-01

Job demands and workload of hospital physicians are increasing. The object of this survey was to examine the factors that constitute job satisfaction and to analyse physicians' work situation in the area of in-patient care. 447 physicians at a German University Hospital received questionnaires with regard to work situation, job satisfaction and personal health. Data were analysed by MANOVA and multiple regression models. A first regression model explained 53% of the variance in satisfaction with "work and profession". Among the explanatory variables "superiors and hierarchy" showed the highest beta-weight (beta = -0.49). "Personal health" also determined job satisfaction, for female physicians stronger (beta = -0.31) than for male physicians (beta = -0.11). In a second regression model on satisfaction with "Financial situation" only 18% of the variance was explained, whereby "work condition on the ward", "personal health" and "collaboration between occupational groups" showed the highest beta-weights. Among resident physicians, work conditions, superiors, hierarchy, transparency and participation in decisions are very important variables for job satisfaction. Improvements in these aspects may improve job satisfaction and help to reduce physician shortage in hospitals.

Success of commonly used operating room management tools in reducing tardiness of first case of the day starts: evidence from German hospitals.

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Ernst, Christian; Szczesny, Andrea; Soderstrom, Naomi; Siegmund, Frank; Schleppers, Alexander

2012-09-01

One of the declared objectives of surgical suite management in Germany is to increase operating room (OR) efficiency by reducing tardiness of first case of the day starts. We analyzed whether the introduction of OR management tools by German hospitals in response to increasing economic pressure was successful in achieving this objective. The OR management tools we considered were the appointment of an OR manager and the development and adoption of a surgical suite governance document (OR charter). We hypothesized that tardiness of first case starts was less in ORs that have adopted one or both of these tools. Using representative 2005 survey data from 107 German anesthesiology departments, we used a Tobit model to estimate the effect of the introduction of an OR manager or OR charter on tardiness of first case starts, while controlling for hospital size and surgical suite complexity. Adoption reduced tardiness of first case starts by at least 7 minutes (mean reduction 15 minutes, 95% confidence interval (CI): 7-22 minutes, P case starts figure prominently the objectives of surgical suite management in Germany. Our results suggest that the appointment of an OR manager or the adoption of an OR charter support this objective. For short-term decision making on the day of surgery, this reduction in tardiness may have economic implications, because it reduced overutilized OR time.

A multi-perspective cost-effectiveness analysis comparing rivaroxaban with enoxaparin sodium for thromboprophylaxis after total hip and knee replacement in the German healthcare setting

Directory of Open Access Journals (Sweden)

Zindel Sonja

2012-07-01

Full Text Available Abstract Background Patients undergoing major orthopaedic surgery (MOS, such as total hip (THR or total knee replacement (TKR, are at high risk of developing venous thromboembolism (VTE. For thromboembolism prophylaxis, the oral anticoagulant rivaroxaban has recently been included in the German diagnosis related group (DRG system. However, the cost-effectiveness of rivaroxaban is still unclear from both the German statutory health insurance (SHI and the German hospital perspective. Objectives To assess the cost-effectiveness of rivaroxaban from the German statutory health insurance (SHI perspective and to analyse financial incentives from the German hospital perspective. Methods Based on data from the RECORD trials and German cost data, a decision tree was built. The model was run for two settings (THR and TKR and two perspectives (SHI and hospital per setting. Results Prophylaxis with rivaroxaban reduces VTE events (0.02 events per person treated after TKR; 0.007 after THR compared with enoxaparin. From the SHI perspective, prophylaxis with rivaroxaban after TKR is cost saving (€27.3 saving per patient treated. However, the cost-effectiveness after THR (€17.8 cost per person remains unclear because of stochastic uncertainty. From the hospital perspective, for given DRGs, the hospital profit will decrease through the use of rivaroxaban by €20.6 (TKR and €31.8 (THR per case respectively. Conclusions Based on our findings, including rivaroxaban for reimbursement in the German DRG system seems reasonable. Yet, adequate incentives for German hospitals to use rivaroxaban are still lacking.

The Application of Standards and Recommendations to Clinical Ethics Consultation in Practice: An Evaluation at German Hospitals.

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Schochow, Maximilian; Rubeis, Giovanni; Steger, Florian

2017-06-01

The executive board of the Academy for Ethics in Medicine (AEM) and two AEM working groups formulated standards and recommendations for clinical ethics consultation in 2010, 2011, and 2013. These guidelines comply with the international standards like those set by the American Society for Bioethics and Humanities. There is no empirical data available yet that could indicate whether these standards and recommendations have been implemented in German hospitals. This desideratum is addressed in the present study. We contacted 1.858 German hospitals between September 2013 and January 2014. A follow-up survey was conducted between October 2014 and January 2015. The data of the initial survey and the follow-up survey were merged and evaluated. The statements of the participants were compared with the standards and recommendations. The standards of the AEM concerning the tasks of clinical ethics consultation (including ethics consultation, ethics training and the establishment of policy guidelines) are employed by a majority of participants of the study. Almost all of these participants document their consultation activities by means of protocols or entries in the patient file. There are deviations from the recommendations of the AEM working groups regarding the drafting of statutes, activity reports, and financial support. The activities of clinical ethics consultation predominantly comply with the standards of the AEM and recommendations for the documentation. The recommendations for evaluation should be improved in practice. This applies particularly for activity reports in order to evaluate the activities. Internal evaluation could take place accordingly.

Pediatric computed tomography practice in Japanese university hospitals from 2008–2010: did it differ from German practice?

International Nuclear Information System (INIS)

Yoshida, Koji; Krille, Lucian; Dreger, Steffen; Hoenig, Lars; Merzenich, Hiltrud; Yasui, Kiyotaka; Kumagai, Atsushi; Ohtsuru, Akira; Uetani, Masataka; Mildenberger, Peter; Takamura, Noboru; Yamashita, Shunichi; Zeeb, Hajo; Kudo, Takashi

2017-01-01

Computed tomography (CT) is an essential tool in modern medicine and is frequently used to diagnose a wide range of conditions, particularly in industrial countries, such as Japan and Germany. However, markedly higher doses of ionizing radiation are delivered during CT imaging than during conventional X-ray examinations. To assess pediatric CT practice patterns, data from three university hospital databases (two in Japan and one in Germany) were analyzed. Anonymized data for patients aged 0 to 14 years who had undergone CT examinations between 2008 and 2010 were extracted. To assess CT practice, an interdisciplinary classification scheme for CT indications, which incorporated the most common examination types and radiosensitive tissues, was developed. The frequency of CT examinations was determined according to sex, age at examination, and indications. A total of 5182 CT examinations were performed in 2955 children. Overall, the frequency of CT examinations at the Japanese university hospitals did not differ significantly from that at the German hospital. However, differences were detected in the age distribution of the patients who underwent CT examinations (the proportion of patients <5 years of age was significantly higher in Japan than in Germany) and in the indications for CT. Substantial practice differences regarding the use of CT in pediatric health care were detected between the three hospitals. The results of this study point towards a need for approaches such as clinical guidelines to reduce unwarranted medical radiation exposures, particularly abdominal and head CT, in the Japanese health system.

Assessment of cardiovascular disease risk in patients with schizophrenia spectrum disorders in German psychiatric hospitals: results of the pharmacoepidemiologic CATS study.

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Deuschle, M; Paul, F; Brosz, M; Bergemann, N; Franz, M; Kammerer-Ciernioch, J; Lautenschlager, M; Lederbogen, F; Roesch-Ely, D; Weisbrod, M; Kahl, K G; Reichmann, J; Gross, J; Umbreit, J

2013-08-01

Patients with severe mental illness are at high risk for metabolic and cardiac disorders. Thus, monitoring of cardiovascular risks is imperative and schedules for screening for lipids, glucose, body mass index (BMI), waist-hip ratio and blood pressure have been developed. We intended to analyze screening for metabolic disorders in German patients with schizophrenia spectrum disorders in routine psychiatric care. We included 674 patients with any F2 diagnosis in out- and inpatient settings and analyzed metabolic screening procedures as practiced under conditions of usual care. Except BMI (54 %), all other values were documented only in a minority of patients: waist circumference (23 %), cholesterol (28 %), fasting glucose (19 %), triglycerides (25 %) and blood pressure (37 %). We found evidence for less than perfect quality of blood pressure measures. The group of patients who met the individual metabolic syndrome ATP III criteria was comparable to the US CATIE trial. We conclude that frequency and quality of metabolic monitoring in German in- and outpatients settings are not in accordance with the respective recommendations. Similar to previous reports we found evidence for a high prevalence of metabolic disturbances in German patients with schizophrenia spectrum disorders.

[Cost assessment for endoscopic procedures in the German diagnosis-related-group (DRG) system - 5 year cost data analysis of the German Society of Gastroenterology project].

Science.gov (United States)

Rathmayer, Markus; Heinlein, Wolfgang; Reiß, Claudia; Albert, Jörg G; Akoglu, Bora; Braun, Martin; Brechmann, Thorsten; Gölder, Stefan K; Lankisch, Tim; Messmann, Helmut; Schneider, Arne; Wagner, Martin; Dollhopf, Markus; Gundling, Felix; Röhling, Michael; Haag, Cornelie; Dohle, Ines; Werner, Sven; Lammert, Frank; Fleßa, Steffen; Wilke, Michael H; Schepp, Wolfgang; Lerch, Markus M

2017-10-01

Background  In the German hospital reimbursement system (G-DRG) endoscopic procedures are listed in cost center 8. For reimbursement between hospital departments and external providers outdated or incomplete catalogues (e. g. DKG-NT, GOÄ) have remained in use. We have assessed the cost for endoscopic procedures in the G-DRG-system. Methods  To assess the cost of endoscopic procedures 74 hospitals, annual providers of cost-data to the Institute for the Hospital Remuneration System (InEK) made their data (2011 - 2015; § 21 KHEntgG) available to the German-Society-of-Gastroenterology (DGVS) in anonymized form (4873 809 case-data-sets). Using cases with exactly one endoscopic procedure (n = 274 186) average costs over 5 years were calculated for 46 endoscopic procedure-tiers. Results  Robust mean endoscopy costs ranged from 230.56 € for gastroscopy (144 666 cases), 276.23 € (n = 32 294) for a simple colonoscopy, to 844.07 € (n = 10 150) for ERCP with papillotomy and plastic stent insertion and 1602.37 € (n = 967) for ERCP with a self-expanding metal stent. Higher costs, specifically for complex procedures, were identified for University Hospitals. Discussion  For the first time this catalogue for endoscopic procedure-tiers, based on § 21 KHEntgG data-sets from 74 InEK-calculating hospitals, permits a realistic assessment of endoscopy costs in German hospitals. The higher costs in university hospitals are likely due to referral bias for complex cases and emergency interventions. For 46 endoscopic procedure-tiers an objective cost-allocation within the G-DRG system is now possible. By international comparison the costs of endoscopic procedures in Germany are low, due to either greater efficiency, lower personnel allocation or incomplete documentation of the real expenses. © Georg Thieme Verlag KG Stuttgart · New York.

Children, care, career - a cross-sectional study on the risk of burnout among German hospital physicians at different career stages.

Science.gov (United States)

Richter, Astrid; Kostova, Petya; Harth, Volker; Wegner, Ralf

2014-01-01

With the increasing number of female medical students physicians' need for work-life balanced hospital jobs rises at all career stages. The Working Time Act (Arbeitszeitgesetz, ArbZG), an implementation of the European Working Time Directive into German law in 2004, should have improved the general conditions for creating flexible work. Nevertheless, the vast majority of female physicians still report an incompatibility of work and family. So far, little is known about mothers working on leading positions in the medical field. The presented study focuses on gender differences in the level of emotional exhaustion between child-rearing junior and senior physicians and different predictors of burnout. Three years after the ArbZT-enactment, 994 physicians from the listed hospital physicians in the Medical Register of the city of Hamburg participated in the cross-sectional study and completed a 60-item questionnaire (return rate of 46,5%). The questionnaire included a 22-item version of the German translation of the Maslach Burnout Inventory whereat emotional exhaustion was interpreted as the crucial predictor of burnout. Results of an univariate covariance analysis and regression analyses are reported. In the level of emotional exhaustion no gender differences were found between junior and senior physicians with children in the overall analysis. Support by the superior was the only overall predictor of burnout. Female senior physicians having children presented the highest risk of burnout. Only in this group parenting contributed significantly to the risk of burnout. Support by the superior and the relationship to colleagues are generally important predictors of burnout among hospital physicians. Parenthood only gets a crucial influence on psychomental health for female senior physicians. Still conservative role models are common in this group, thus dealing with the triple burden of work, leadership responsibility and child rearing seems to be a special female

German diabetes management programs improve quality of care and curb costs.

Science.gov (United States)

Stock, Stephanie; Drabik, Anna; Büscher, Guido; Graf, Christian; Ullrich, Walter; Gerber, Andreas; Lauterbach, Karl W; Lüngen, Markus

2010-12-01

This paper reports the results of a large-scale analysis of a nationwide disease management program in Germany for patients with diabetes mellitus. The German program differs markedly from "classic" disease management in the United States. Although it combines important hallmarks of vendor-based disease management and the Chronic Care Model, the German program is based in primary care practices and carried out by physicians, and it draws on their personal relationships with patients to promote adherence to treatment goals and self-management. After four years of follow-up, overall mortality for patients and drug and hospital costs were all significantly lower for patients who participated in the program compared to other insured patients with similar health profiles who were not in the program. These results suggest that the German disease management program is a successful strategy for improving chronic illness care.

Web-based Training an deutschen Universitäts-Augenkliniken – Lehre 2.0? [Web-based Training in German University Eye Hospitals – Education 2.0?

Directory of Open Access Journals (Sweden)

Handzel, Daniel M.

2011-08-01

Full Text Available [english] Purpose: To analyse web-based training in ophthalmology offered by German university eye hospitals. Methods: In January 2010 the websites of all 36 German university hospitals were searched for information provided for visitors, students and doctors alike. We evaluated the offer in terms of quantity and quality. Results: All websites could be accessed at the time of the study. 28 pages provided information for students and doctors, one page only for students, three exclusively for doctors. Four pages didn’t offer any information for these target groups. The websites offered information on events like congresses or students curricular education, there were also material for download for these events or for other purposes. We found complex e-learning-platforms on 9 pages. These dealt with special ophthalmological topics in a didactic arrangement. In spite of the extensive possibilities offered by the technology of Web 2.0, many conceivable tools were only rarely made available. It was not always possible to determine if the information provided was up-to-date, very often the last actualization of the content was long ago. On one page the date for the last change was stated as 2004. Conclusion: Currently there are 9 functional e-learning-applications offered by German university eye hospitals. Two additional hospitals present links to a project of the German Ophthalmological Society. There was a considerable variation in quantity and quality. No website made use of crediting successful studying, e.g. with CME-points or OSCE-credits. All German university eye hospitals present themselves in the World Wide Web. However, the lack of modern, technical as well as didactical state-of-the-art learning applications is alarming as it leaves an essential medium of today’s communication unused. [german] Zielsetzung: Analyse der webbasierten ophthalmologischen Lernprogramme, welche von den Internetseiten der Universitäts-Augenkliniken in

The German clinical risk management survey for hospitals: Implementation levels and areas for improvement in 2015.

Science.gov (United States)

Manser, Tanja; Frings, Janina; Heuser, Gregory; Mc Dermott, Fiona

2016-01-01

Despite the growing recognition of the need to implement systematic approaches for managing the risks associated with healthcare, few studies have investigated the level of implementation for clinical risk management (CRM) at a national level. Therefore, this study aimed to assess the current level of CRM implementation in German hospitals and to explore differences across hospital types. From March to June 2015, persons responsible for CRM in 2,617 hospitals and rehabilitation clinics in Germany were invited to participate in a voluntary online survey assessing the level of implementation for various aspects of CRM: CRM strategy, structures and processes; risk assessment (risk identification, risk analysis, risk evaluation) with a focus on incident reporting systems; risk mitigation measures; and risk monitoring and reporting. 572 hospitals participated in the survey (response rate 22 %). Most of these hospitals had a formalised, binding CRM strategy (72 %). 66 % had a centralised and 34 % a decentralised CRM structure. We also found that, despite a broad range of risk assessment methods being applied, there was a lack of integration of risk information from different data sources. Hospitals also reported a high level of implementation of critical incident reporting systems with a strong preference for local (74 %) over transorganisational systems. This study provides relevant data to inform targeted interventions concerning CRM implementation at a national level and to consider the specific context of different types of hospitals more carefully in this process. The approach to CRM assessment illustrated in this article could be the basis of a system for monitoring CRM over time and, thus, for evaluating the impact of strategy decisions at the policy level on CRM development. Copyright © 2016. Published by Elsevier GmbH.

Management and minimisation of uncertainties and errors in numerical aerodynamics results of the German collaborative project MUNA

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Barnewitz, Holger; Fritz, Willy; Thiele, Frank

2013-01-01

This volume reports results from the German research initiative MUNA (Management and Minimization of Errors and Uncertainties in Numerical Aerodynamics), which combined development activities of the German Aerospace Center (DLR), German universities and German aircraft industry. The main objective of this five year project was the development of methods and procedures aiming at reducing various types of uncertainties that are typical of numerical flow simulations. The activities were focused on methods for grid manipulation, techniques for increasing the simulation accuracy, sensors for turbulence modelling, methods for handling uncertainties of the geometry and grid deformation as well as stochastic methods for quantifying aleatoric uncertainties.

Quality of human-computer interaction - results of a national usability survey of hospital-IT in Germany

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Bundschuh Bettina B

2011-11-01

Full Text Available Abstract Background Due to the increasing functionality of medical information systems, it is hard to imagine day to day work in hospitals without IT support. Therefore, the design of dialogues between humans and information systems is one of the most important issues to be addressed in health care. This survey presents an analysis of the current quality level of human-computer interaction of healthcare-IT in German hospitals, focused on the users' point of view. Methods To evaluate the usability of clinical-IT according to the design principles of EN ISO 9241-10 the IsoMetrics Inventory, an assessment tool, was used. The focus of this paper has been put on suitability for task, training effort and conformity with user expectations, differentiated by information systems. Effectiveness has been evaluated with the focus on interoperability and functionality of different IT systems. Results 4521 persons from 371 hospitals visited the start page of the study, while 1003 persons from 158 hospitals completed the questionnaire. The results show relevant variations between different information systems. Conclusions Specialised information systems with defined functionality received better assessments than clinical information systems in general. This could be attributed to the improved customisation of these specialised systems for specific working environments. The results can be used as reference data for evaluation and benchmarking of human computer engineering in clinical health IT context for future studies.

[Cost of intensive care in a German hospital: cost-unit accounting based on the InEK matrix].

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Martin, J; Neurohr, C; Bauer, M; Weiss, M; Schleppers, A

2008-05-01

The aim of this study was to determine the actual cost per intensive care unit (ICU) day in Germany based on routine data from an electronic patient data management system as well as analysis of cost-driving factors. A differentiation between days with and without mechanical ventilation was performed. On the ICU of a German focused-care hospital (896 beds, 12 anesthesiology ICU beds), cost per treatment day was calculated with or without mechanical ventilation from the perspective of the hospital. Costs were derived retrospectively with respect to the period between January and October 2006 by cost-unit accounting based on routine data collected from the ICU patients. Patients with a length of stay of at least 2 days on the ICU were included. Demographic, clinical and economical data were analyzed for patient characterization. Data of 407 patients (217 male and 190 female) were included in the analysis, of which 159 patients (100 male, 59 female) were completely or partially mechanically ventilated. The mean simplified acute physiology (SAPS) II score at the onset of ICU stay was 28.2. Average cost per ICU day was 1,265 EUR and costs for ICU days with and without mechanical ventilation amounted to 1,426 EUR and 1,145 EUR, respectively. Personnel costs (50%) showed the largest cost share followed by drugs plus medicinal products (18%) and infrastructure (16%). For the first time, a cost analysis of intensive care in Germany was performed with routine data based on the matrix of the institute for reimbursement in hospitals (InEK). The results revealed a higher resource use on the ICU than previously expected. The large share of personnel costs on the ICU was evident but is comparable to other medical departments in the hospital. The need for mechanical ventilation increases the daily costs of resources by approximately 25%.

Review on the present status of the German Risk Study: overall results

International Nuclear Information System (INIS)

Heuser, F.W.

1982-01-01

An overview on the most important results of the German Risk Study (Phase A) is given. Besides plant design analysis, the description mainly refers to core melt accidents, radioactive release and accidental consequences depending on various types of containment failure. Thereby some differences or results compared to WASH 1400 are discussed

Joint crisis plans and psychiatric advance directives in German psychiatric practice.

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Radenbach, Katrin; Falkai, Peter; Weber-Reich, Traudel; Simon, Alfred

2014-05-01

This study explores the attitude of German psychiatrists in leading positions towards joint crisis plans and psychiatric advance directives. This topic was examined by contacting 473 medical directors of German psychiatric hospitals and departments. They were asked to complete a questionnaire developed by us. That form contained questions about the incidence and acceptance of joint crisis plans and psychiatric advance directives and previous experiences with them. 108 medical directors of psychiatric hospitals and departments responded (response rate: 22.8%). Their answers demonstrate that in their hospitals these documents are rarely used. Among the respondents, joint crisis plans are more accepted than psychiatric advance directives. There is a certain uncertainty when dealing with these instruments. Our main conclusion is that German psychiatry needs an intensified discussion on the use of instruments for patients to constitute procedures for future critical psychiatric events. For this purpose it will be helpful to collect more empirical data. Furthermore, the proposal of joint crisis plans in psychiatric hospitals and departments should be discussed as well as the possibility of consulting an expert during the preparation of a psychiatric advance directive.

VHB-JOURQUAL2: Method, Results, and Implications of the German Academic Association for Business Research's Journal Ranking

OpenAIRE

Schrader, Ulf; Hennig-Thurau, Thorsten

2009-01-01

VHB-JOURQUAL represents the official journal ranking of the German Academic Association for Business Research. Since its introduction in 2003, the ranking has become the most influential journal evaluation approach in German-speaking countries, impacting several key managerial decisions of German, Austrian, and Swiss business schools. This article reports the methodological approach of the ranking’s second edition. It also presents the main results and additional analyses on the validity of t...

Epidemiology of Extended-Spectrum β-Lactamase-Producing E. coli and Vancomycin-Resistant Enterococci in the Northern Dutch-German Cross-Border Region.

Science.gov (United States)

Zhou, Xuewei; García-Cobos, Silvia; Ruijs, Gijs J H M; Kampinga, Greetje A; Arends, Jan P; Borst, Dirk M; Möller, Lieke V; Holman, Nicole D; Schuurs, Theo A; Bruijnesteijn van Coppenraet, Lesla E; Weel, Jan F; van Zeijl, Jan H; Köck, Robin; Rossen, John W A; Friedrich, Alexander W

2017-01-01

Objectives: To reveal the prevalence and epidemiology of extended-spectrum β-lactamase (ESBL)- and/or plasmid AmpC (pAmpC)- and carbapenemase (CP) producing Enterobacteriaceae and vancomycin-resistant enterococci (VRE) across the Northern Dutch-German border region. Methods: A point-prevalence study on ESBL/pAmpC/CP producing Enterobacteriaceae and VRE was carried out in hospitalized patients in the Northern Netherlands ( n = 445, 2012-2013) and Germany ( n = 242, 2012). Healthy individuals from the Dutch community ( n = 400, 2010-2012) were also screened. In addition, a genome-wide gene-by-gene approach was applied to study the epidemiology of ESBL- Escherichia coli and VRE. Results: A total of 34 isolates from 27 patients (6.1%) admitted to Dutch hospitals were ESBL/pAmpC positive and 29 ESBL- E. coli , three pAmpC- E. coli , one ESBL- Enterobacter cloacae , and one pAmpC- Proteus mirabilis were found. In the German hospital, 18 isolates (16 E. coli and 2 Klebsiella pneumoniae ) from 17 patients (7.7%) were ESBL positive. In isolates from the hospitalized patients CTX-M-15 was the most frequently detected ESBL-gene. In the Dutch community, 11 individuals (2.75%) were ESBL/pAmpC positive: 10 ESBL - E. coli (CTX-M-1 being the most prevalent gene) and one pAmpC E. coli . Six Dutch (1.3%) and four German (3.9%) hospitalized patients were colonized with VRE. Genetic relatedness by core genome multi-locus sequence typing (cgMLST) was found between two ESBL- E. coli isolates from Dutch and German cross-border hospitals and between VRE isolates from different hospitals within the same region. Conclusion: The prevalence of ESBL/pAmpC- Enterobacteriaceae was similar in hospitalized patients across the Dutch-German border region, whereas VRE prevalence was slightly higher on the German side. The overall prevalence of the studied pathogens was lower in the community than in hospitals in the Northern Netherlands. Cross-border transmission of ESBL- E. coli and VRE seems

Epidemiology of Extended-Spectrum β-Lactamase-Producing E. coli and Vancomycin-Resistant Enterococci in the Northern Dutch–German Cross-Border Region

Directory of Open Access Journals (Sweden)

Xuewei Zhou

2017-10-01

Full Text Available Objectives: To reveal the prevalence and epidemiology of extended-spectrum β-lactamase (ESBL- and/or plasmid AmpC (pAmpC- and carbapenemase (CP producing Enterobacteriaceae and vancomycin-resistant enterococci (VRE across the Northern Dutch–German border region.Methods: A point-prevalence study on ESBL/pAmpC/CP producing Enterobacteriaceae and VRE was carried out in hospitalized patients in the Northern Netherlands (n = 445, 2012–2013 and Germany (n = 242, 2012. Healthy individuals from the Dutch community (n = 400, 2010–2012 were also screened. In addition, a genome-wide gene-by-gene approach was applied to study the epidemiology of ESBL-Escherichia coli and VRE.Results: A total of 34 isolates from 27 patients (6.1% admitted to Dutch hospitals were ESBL/pAmpC positive and 29 ESBL-E. coli, three pAmpC-E. coli, one ESBL-Enterobacter cloacae, and one pAmpC-Proteus mirabilis were found. In the German hospital, 18 isolates (16 E. coli and 2 Klebsiella pneumoniae from 17 patients (7.7% were ESBL positive. In isolates from the hospitalized patients CTX-M-15 was the most frequently detected ESBL-gene. In the Dutch community, 11 individuals (2.75% were ESBL/pAmpC positive: 10 ESBL-E. coli (CTX-M-1 being the most prevalent gene and one pAmpC E. coli. Six Dutch (1.3% and four German (3.9% hospitalized patients were colonized with VRE. Genetic relatedness by core genome multi-locus sequence typing (cgMLST was found between two ESBL-E. coli isolates from Dutch and German cross-border hospitals and between VRE isolates from different hospitals within the same region.Conclusion: The prevalence of ESBL/pAmpC-Enterobacteriaceae was similar in hospitalized patients across the Dutch–German border region, whereas VRE prevalence was slightly higher on the German side. The overall prevalence of the studied pathogens was lower in the community than in hospitals in the Northern Netherlands. Cross-border transmission of ESBL-E. coli and VRE seems unlikely

Main results of the German risk study - phase B

International Nuclear Information System (INIS)

Heuser, F.W.

1987-01-01

To start the author introduces briefly some comments on main tasks and objectives of risk analysises which at least after the Chernobyl accident should be emphasized more explicitly. Following on some main results of the system - and accident event tree analysis of the German Risk Study, Phase B, are summarized. The second part of this paper deals with the analysis of core melt accidents performed in context of the study. Hetero investigations on the hydrogen problem and investigations on containment venting after a core melt accident will be discussed in more detail

Predictors of BMI Vary along the BMI Range of German Adults – Results of the German National Nutrition Survey II

Science.gov (United States)

Moon, Kilson; Krems, Carolin; Heuer, Thorsten; Roth, Alexander; Hoffmann, Ingrid

2017-01-01

Objective The objective of the study was to identify predictors of BMI in German adults by considering the BMI distribution and to determine whether the association between BMI and its predictors varies along the BMI distribution. Methods The sample included 9,214 adults aged 18–80 years from the German National Nutrition Survey II (NVS II). Quantile regression analyses were conducted to examine the association between BMI and the following predictors: age, sports activities, socio-economic status (SES), healthy eating index-NVS II (HEI-NVS II), dietary knowledge, sleeping duration and energy intake as well as status of smoking, partner relationship and self-reported health. Results Age, SES, self-reported health status, sports activities and energy intake were the strongest predictors of BMI. The important outcome of this study is that the association between BMI and its predictors varies along the BMI distribution. Especially, energy intake, health status and SES were marginally associated with BMI in normal-weight subjects; this relationships became stronger in the range of overweight, and were strongest in the range of obesity. Conclusions Predictors of BMI and the strength of these associations vary across the BMI distribution in German adults. Consequently, to identify predictors of BMI, the entire BMI distribution should be considered. PMID:28219069

Results of a German probabilistic risk assessment study for the HTR-1160 concept

International Nuclear Information System (INIS)

Fassbender, J.; Kroeger, W.

1981-01-01

The paper reviews ''Accident Initiations and Progression Analysis'' methodology and results which applied to the German equivalent of the HTGR-1160 and German site conditions. The investigation of accidents contributing to risk was concentrated on those event sequences which lead to major release of core inventory or - with less importance - to release of plate-out activity together with coolant gas activity. With regard to release mechanisms severe HTR-accidents were grouped into: a) water ingress events with fission product release due to hydrolysis of defective coated particles and desorption of plate out activity and b) core heating events with fission product release after coated particle failure due to excessive temperatures

Results of a German probabilistic risk assessment study for the HTR-1160 concept

Energy Technology Data Exchange (ETDEWEB)

Fassbender, J.; Kroeger, W. [Kernforschungsanlage Juelich G.m.b.H. (Germany, F.R.). Inst. fuer Nukleare Sicherheitsforschung

1981-01-15

The paper reviews ''Accident Initiations and Progression Analysis'' methodology and results which applied to the German equivalent of the HTGR-1160 and German site conditions. The investigation of accidents contributing to risk was concentrated on those event sequences which lead to major release of core inventory or - with less importance - to release of plate-out activity together with coolant gas activity. With regard to release mechanisms severe HTR-accidents were grouped into: a) water ingress events with fission product release due to hydrolysis of defective coated particles and desorption of plate out activity and b) core heating events with fission product release after coated particle failure due to excessive temperatures.

Association between hospital procedure volume and early complications after pacemaker implantation: results from a large, unselected, contemporary cohort of the German nationwide obligatory external quality assurance programme.

Science.gov (United States)

Nowak, Bernd; Tasche, Karl; Barnewold, Linda; Heller, Günther; Schmidt, Boris; Bordignon, Stefano; Chun, K R Julian; Fürnkranz, Alexander; Mehta, Rajendra H

2015-05-01

Several studies demonstrated an inverse relationship between cardioverter-defibrillator implantation volume and complication rates, suggesting better outcomes for higher volume centres. However, the association of institutional procedural volume with patient outcomes for permanent pacemaker (PPM) implantation remains less known, especially in decentralized implantation systems. We performed retrospective examination of data on patients undergoing PPM from the German obligatory quality assurance programme (2007-12) to evaluate the relationship of hospital PPM volume (categorized into quintiles of their mean annual volume) with risk-adjusted in-hospital surgical complications (composite of pneumothorax, haemothorax, pericardial effusion, or pocket haematoma, all requiring intervention, or device infection) and pacemaker lead dislocation. Overall 430 416 PPM implantations were documented in 1226 hospitals. Systems included dual (72.8%) and single (25.8%) chamber PPM and cardiac resynchronization therapy (CRT) devices (1.1%). Complications included surgical (0.92%), and ventricular (0.99%), and atrial (1.22%) lead dislocation. Despite an increase in relatively complex procedures (dual chamber, CRT), there was a significant decrease in the procedural and fluoroscopy times and complications from lowest to highest implantation volume quintiles (P for trend <0.0001). The greatest difference was observed between the lowest (1-50 implantations/year-reference group) and the second-lowest (51-90 implantations/year) quintile: surgical complications [odds ratio (OR) 0.69; confidence interval (CI) 0.60-0.78], atrial lead dislocations (OR 0.69; CI 0.59-0.80), and ventricular lead dislocations (OR 0.73; CI 0.63-0.84). Hospital annual PPM volume was directly related to indication-based implantation of relatively more complex PPM and yet inversely with procedural times and rates of early surgical complications and lead dislocations. Thus, our data suggest better performance and lower

[Systematic Readability Analysis of Medical Texts on Websites of German University Clinics for General and Abdominal Surgery].

Science.gov (United States)

Esfahani, B Janghorban; Faron, A; Roth, K S; Grimminger, P P; Luers, J C

2016-12-01

Background: Besides the function as one of the main contact points, websites of hospitals serve as medical information portals. As medical information texts should be understood by any patients independent of the literacy skills and educational level, online texts should have an appropriate structure to ease understandability. Materials and Methods: Patient information texts on websites of clinics for general surgery at German university hospitals (n = 36) were systematically analysed. For 9 different surgical topics representative medical information texts were extracted from each website. Using common readability tools and 5 different readability indices the texts were analysed concerning their readability and structure. The analysis was furthermore stratified in relation to geographical regions in Germany. Results: For the definite analysis the texts of 196 internet websites could be used. On average the texts consisted of 25 sentences and 368 words. The reading analysis tools congruously showed that all texts showed a rather low readability demanding a high literacy level from the readers. Conclusion: Patient information texts on German university hospital websites are difficult to understand for most patients. To fulfill the ambition of informing the general population in an adequate way about medical issues, a revision of most medical texts on websites of German surgical hospitals is recommended. Georg Thieme Verlag KG Stuttgart · New York.

[German nurses during the First World War].

Science.gov (United States)

Wagner, Franz

2014-06-01

Nurses from several German organisations participated in the First World War. For the most part, they did not work on the frontline but at the rear, in hospital trains, hospitals or refugee camps. They cared forwounded soldiers and faced epidemics of infectious diseases. The journal of the national association of nurses, which continued to be published during the war, provides a snapshot of their concerns and their questioning regarding the profession and its evolution.

[The "Psychiatrie-Enquete" - the German Report on the State of Psychiatry in 1975].

Science.gov (United States)

Finzen, Asmus

2015-10-01

Forty years ago an expert-commission submitted a report on the deplorable state of German psychiatric care, called the "Psychiatrie-Enquete" to the Bundestag, the German parliament. The Report initiated a substantial change of Psychiatric services in the country. Inhuman treatment and living conditions were superseded. Mental hospitals were not completely abolished. But they lost their importance in favour of decentralized psychiatric services including departments at general hospitals, day hospitals and outpatient services. Custodial care was largely successfully developed into therapeutic and rehabilitative care. This article attempts a mildly critical evaluation of the Enquête 40 years after. © Georg Thieme Verlag KG Stuttgart · New York.

[Adjustment of the German DRG system in 2009].

Science.gov (United States)

Wenke, A; Franz, D; Pühse, G; Volkmer, B; Roeder, N

2009-07-01

The 2009 version of the German DRG system brought significant changes for urology concerning coding of diagnoses, medical procedures and the DRG structure. In view of the political situation and considerable economic pressure, a critical analysis of the 2009 German DRG system is warranted. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2008 and 2009 based on the publications of the German DRG-institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). The relevant diagnoses, medical procedures and German DRGs in the versions 2008 and 2009 were analysed based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2009 focus on the development of the DRG structure, DRG validation and codes for medical procedures to be used for very complex cases. The outcome of these changes for German hospitals may vary depending in the range of activities. The German DRG system again gained complexity. High demands are made on correct and complete coding of complex urology cases. The quality of case allocation in the German DRG system was improved. On the one hand some of the old problems (e.g. enterostomata) still persist, while on the other hand new problems evolved out of the attempt to improve the case allocation of highly complex and expensive cases. Time will tell whether the increase in highly specialized DRG with low case numbers will continue to endure and reach acceptable rates of annual fluctuations.

[The German program for disease management guidelines. Results and perspectives].

Science.gov (United States)

Ollenschläger, Günter; Kopp, Ina

2007-05-15

The Program for National Disease Management Guidelines (German DM-CPG Program) is a joint initiative of the German Medical Association (umbrella organization of the German Chambers of Physicians), the Association of the Scientific Medical Societies (AWMF), and of the National Association of Statutory Health Insurance Physicians (NASHIP). The program aims at developing, implementing and continuously updating best-practice recommendations for countrywide and regional disease management programs in Germany. Since 2003 twelve national guidelines (topics: asthma, chronic obstructive pulmonary disease, HI (Chronic heart failure), CVD (Chronic coronary heart disease) back pain, depression, several aspects of diabetes) have been produced by use of a standardized procedure in accordance with internationally consented methodologies. For countrywide dissemination and implementation the program uses a wide range of specialist journals, continuous medical education and quality management programs. So far, 36 out of 150 national scientific medical associations, four allied health profession organizations, and twelve national consumer organizations have been participating in the DM-CPG Program. Studies to evaluate the program's effects on health-care providers' behavior and patients' outcomes are under way.

[German ophthalmologists and NSDAP

Science.gov (United States)

Rohrbach, Jens Martin

2008-01-01

Approximately 40-45 % of all German physicians joined the National Socialist German Workers Party (NSDAP) until 1945. Reasons for party membership are manifold and still a matter of debate. Very likely, the extraordinary high representation of medical doctors in the NSDAP was rather a result of active entry than recruitment by the party. There are only few data concerning the willingness of ophthalmologists to become a party member ("Parteigenosse", "Pg"). According to the list of University teachers in Germany ("Hochschullehrerkarte"; Federal Archive, Berlin), the list of the members of the German Ophthalmological Society (DOG) of 1934 and especially the list of NSDAP-members (Federal Archive, Berlin) the following conclusions can be drawn: 1. Directors of German University eye hospitals (chairmen) were members of the NSDAP with a frequency of 23% in 1933 and 48% in 1938 as well as in 1943. The motivation for joining the party was most likely the perspective of acceleration of the academic career. 2. "Only" 30% of the ophthalmologists working in private praxis were "Pg" (until 1945). 3. Both chairmen and ophthalmologists in private praxis were equally hindered to join the NSDAP between May 1st 1933 and May 1st 1937 when the party temporarily stopped registration. 4. The majority of ophthalmologists who joined the NSDAP were born between 1880 and 1900 and thus had taken part in World War I as soldiers or had experienced the times of need after WW I. Only few ophthalmologists succeeded in the NS-hierarchy and probably only one ophthalmologist, Walther Löhlein from Berlin, came in personal contact with Adolf Hitler who was constantly in fear for his sight after his eye injury in October 1918. The "Law for the prevention of genetically disabled offsprings" ("Gesetz zur Verhütung erbkranken Nachwuchses") from July 14th, 1933 separated ophthalmologists into two parties: those advocating sterilization to a high degree and those recommending sterilization only

Nurses and opioids: results of a bi-national survey on mental models regarding opioid administration in hospitals

Directory of Open Access Journals (Sweden)

Guest C

2017-03-01

Full Text Available Charlotte Guest,1 Fabian Sobotka,2 Athina Karavasopoulou,3 Stephen Ward,3 Carsten Bantel4,5 1Pain Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; 2Division of Epidemiology and Biometry, Department of Health Services Research, Faculty 6, Medicine and Health Sciences, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany; 3Pain Service, Barts Health, St Bartholomew’s Hospital, London, UK; 4Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Oldenburg University, Klinikum Oldenburg Campus, Oldenburg, Germany; 5Department of Surgery and Cancer, Anaesthetics Section, Imperial College London, Chelsea and Westminster Hospital Campus, London, UK Objective: Pain remains insufficiently treated in hospitals. Increasing evidence suggests human factors contribute to this, due to nurses failing to administer opioids. This behavior might be the consequence of nurses’ mental models about opioids. As personal experience and conceptions shape these models, the aim of this prospective survey was to identify model-influencing factors. Material and methods: A questionnaire was developed comprising of 14 statements concerning ideations about opioids and seven questions concerning demographics, indicators of adult learning, and strength of religious beliefs. Latent variables that may underlie nurses’ mental models were identified using undirected graphical dependence models. Representative items of latent variables were employed for ordinal regression analysis. Questionnaires were distributed to 1,379 nurses in two London, UK, hospitals (n=580 and one German (n=799 hospital between September 2014 and February 2015. Results: A total of 511 (37.1% questionnaires were returned. Mean (standard deviation age of participants were 37 (11 years; 83.5% participants were female; 45.2% worked in critical care; and 51.5% had more than 10 years experience. Of the nurses, 84% were not scared of opioids, 87

Dietary iron intake and iron status of German female vegans: results of the German vegan study.

Science.gov (United States)

Waldmann, Annika; Koschizke, Jochen W; Leitzmann, Claus; Hahn, Andreas

2004-01-01

As shown in previous studies vegetarians and especially vegans are at risk for iron deficiency. Our study evaluated the iron status of German female vegans. In this cross-sectional study, the dietary intakes of 75 vegan women were assessed by two 9-day food frequency questionnaires. The iron status was analyzed on the basis of blood parameters. Mean daily iron intake was higher than recommended by the German Nutrition Society. Still 42% of the female vegans or = 50 years (old women, OW). In all, 40% (tri-index model (TIM) 20%) of the YW and 12% (TIM 12%) of the OW were considered iron-deficient based on either serum ferritin levels of vegan diet should have their iron status monitored and should consider taking iron supplements in case of a marginal status. Copyright 2004 S. Karger AG, Basel

"We call it Springbok-German!": language contact in the German communities in South Africa.

OpenAIRE

Franke, Katharina

2017-01-01

Varieties of German are spoken all over the world, some of which have been maintained for prolonged periods of time. As a result, these transplanted varieties often show traces of the ongoing language contact as specific to their particular context. This thesis explores one such transplanted German language variety – Springbok- German – as spoken by a small subset of German Lutherans in South Africa. Specifically, this study takes as its focus eight rural German communities acr...

The German remote monitoring field test -- First results

International Nuclear Information System (INIS)

Richter, B.; Neumann, G.; Rudolf, K.; Schink, F.J.; Johnson, C.S.; Martinez, R.L.

1996-01-01

The International Atomic Energy Agency strives to increase the efficiency of its safeguards by reducing the inspection effort without losing safeguards effectiveness. Remote data transmission may have a potential to automate routine safeguards. The German government sponsors a field trial to study technical and non-technical issues related to the remote transmission of safeguards and status data as well as mailing-in of data carriers. Major technical issues of the field trial are the authenticity and confidentiality of the remotely received data as well as the reliability of the transmission techniques and data storage on removable data carriers. Non-technical issues are related to the release of data including the timing of data transmissions. The field trial takes place in the commercial Ahaus Dry Storage Facility for Spent Nuclear Fuel with participation of Sandia National Laboratories. The paper describes the first results

[Orthopedic and trauma surgery in the German DRG system 2008].

Science.gov (United States)

Franz, D; Kaufmann, M; Siebert, C H; Windolf, J; Roeder, N

2008-04-01

The German DRG (diagnosis-related groups) system has been modified and updated into version 2008. For orthopedic and trauma surgery significant changes concerning coding of diagnoses, medical procedures and the DRG structure were made. The modified version has been analyzed in order to ascertain whether the DRG system is suitably qualified to fulfill the demands of the reimbursement system or whether further improvements are necessary. Analysis of the severity of relevant side-effect diagnoses, medical procedures and G-DRGs in the versions 2007 and 2008 was carried out based on the publications of the German DRG institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2008 focused on the development of DRG structure, DRG validation and codes for medical procedures. The outcome of these changes for German hospitals may vary depending on the range of activities. G-DRG system has become even more complex and the new regulations have also resulted in new problems associated with complications.. High demands are made on correct and complete coding of complex orthopedic and trauma surgery cases. Quality of case allocation within the G-DRG system has been improved. Nevertheless, further improvements of the G-DRG system are necessary, especially for cases with severe injuries.

[The fate of Polish psychiatry under German occupation during World War II].

Science.gov (United States)

Leidinger, Friedrich

2014-07-01

Polish psychiatry was since its origin deeply influenced by German (Austrian) and Russian psychiatry. After the German assault Polish psychiatric patients were the first victims of mass executions, and the first to be killed by new developed "gassing" technology. Especially cruel was the fate of Jewish patients. German "health policy" in occupied Poland was only "starvation or shooting". Some hospitals continued working under German rule and received patients from Germany in the framework of Nazi-"euthanasia". The article describes the mostly ignored facts of the close link between the medical programme of annihilation of the "unfit" and the genocide of Poles and Jews. © Georg Thieme Verlag KG Stuttgart · New York.

Fine-grained information extraction from German transthoracic echocardiography reports.

Science.gov (United States)

Toepfer, Martin; Corovic, Hamo; Fette, Georg; Klügl, Peter; Störk, Stefan; Puppe, Frank

2015-11-12

Information extraction techniques that get structured representations out of unstructured data make a large amount of clinically relevant information about patients accessible for semantic applications. These methods typically rely on standardized terminologies that guide this process. Many languages and clinical domains, however, lack appropriate resources and tools, as well as evaluations of their applications, especially if detailed conceptualizations of the domain are required. For instance, German transthoracic echocardiography reports have not been targeted sufficiently before, despite of their importance for clinical trials. This work therefore aimed at development and evaluation of an information extraction component with a fine-grained terminology that enables to recognize almost all relevant information stated in German transthoracic echocardiography reports at the University Hospital of Würzburg. A domain expert validated and iteratively refined an automatically inferred base terminology. The terminology was used by an ontology-driven information extraction system that outputs attribute value pairs. The final component has been mapped to the central elements of a standardized terminology, and it has been evaluated according to documents with different layouts. The final system achieved state-of-the-art precision (micro average.996) and recall (micro average.961) on 100 test documents that represent more than 90 % of all reports. In particular, principal aspects as defined in a standardized external terminology were recognized with f 1=.989 (micro average) and f 1=.963 (macro average). As a result of keyword matching and restraint concept extraction, the system obtained high precision also on unstructured or exceptionally short documents, and documents with uncommon layout. The developed terminology and the proposed information extraction system allow to extract fine-grained information from German semi-structured transthoracic echocardiography reports

[Caught between economic pressure and work-life balance--perspectives on emigration of German health professionals to Austria].

Science.gov (United States)

Schmidt, A E; Klambauer, E

2014-05-01

Given the increasing lack of medical doctors in Germany, this study aimed to investigate the professional situation and the push and pull factors of German medical specialists working in Austrian hospitals. This explorative study is based on semi-structured interviews with 14 specialists working in Austria, who completed their education partly or fully in Germany. The material has been interpreted using qualitative content analysis. Better work-life balance, higher quality of life and more favourable working conditions represent major reasons for German specialists to stay in Austria. Moreover, the higher density of medical doctors in Austrian hospitals can have an impact on the distribution of responsibilities among health-care personnel, and on hospital performance. In the light of recent reforms in the German health-care system, the study underlines the importance of qualitative factors for the satisfaction of German medical doctors. These factors should be further analysed in order to avoid a brain drain of high-qualified health care staff in the future. © Georg Thieme Verlag KG Stuttgart · New York.

Results of German support programme to implement the UN FCCC

Energy Technology Data Exchange (ETDEWEB)

Liptow, H. [GTZ, Eschborn (Germany)

1996-12-31

This paper presents a summary of German efforts in support of implementing the Framework Convention on Climate Change (FCCC). Following the Rio conference, the task of supporting outreach efforts was given to the GTZ since that is its general function, and within the context of German Technical Co-operation (TC), a program was implemented. Their initial effort was directed at helping implement inventory studies in target countries, including studies of options for reducing emissions. Once a level of information and factual knowledge was in place, they presented the type of technical support which Germany could offer in meeting the needs envisioned to achieve reduced emissions, in the form of technical co-operation. Experiences are discussed for the cases of a number of different participating countries.

East German medical aid to Nicaragua: the politics of solidarity between biomedicine and primary health care.

Science.gov (United States)

Borowy, Iris

2017-01-01

Between 1979 and 1989 the government of the German Democratic Republic provided health assistance to Sandinista Nicaragua. After initial relief aid, the Sandinista embrace of a primary health care-based health system made East German health support difficult. The non-convertible currency, the repressive quality of the East German leadership, and the lack of experience with primary health care processes all limited its potential to provide support. After 1985, when implementation of this system stalled, East German health assistance was revitalized with the donation of the Hospital Carlos Marx. Providing medical services to three hundred thousand people, it combined elements of a strictly East German institution, using German personnel and equipment, with some integration into local systems.

SOFT POWER: TRAINING OF VET TEACHERS AND TRAINERS (RESULTS OF THE RUSSIAN-GERMAN COOPERATION

Directory of Open Access Journals (Sweden)

E. Yu. Esenina

2017-01-01

Full Text Available Introduction. Nowadays, in Russia the system of interaction between educational institutions and enterprises-employers in training of specialists is being built again after more than a twenty-year period of dissociation. Sharing experiences with other countries on networking and strengthening of education relations with production is very useful for establishing this process. The aim of the publication is to present the results of the Russian-German cooperation in the field of preparation of the qualified pedagogical staff for the system of vocational education as one of the key conditions for ensuring the proper quality of vocational education. Methodology and research methods. The methods involve the methodology of comparative research; methods of collecting empirical information; conceptual and terminological analysis, interpretation, modeling, and problem method. Results. The approaches to preparation of pedagogical staff of the VET system in Germany and Russia are revealed and compared. Specifics of the German model are shown: existence of several skill levels of teachers of vocational education, distribution of zones of their responsibility, variability of providers of additional education, its market nature and minimum participation in its regulation of the state. Features of the modern Russian theory and training experience of instructors of vocational training are described. Despite the existing distinctions of systems of professional education of two countries, the similarity of the Russian and German methods of vocational education is observed. The conclusion is drawn on a community of requirements imposed in Germany and Russia to category of the workers who are carrying out staff training for manufacturing sectors. It is confirmed by the German experts on the basis of the analysis of the standard «Teacher of Vocational Education, Professional Education and Additional Professional Education». Also, the standard was checked and

Nurses and opioids: results of a bi-national survey on mental models regarding opioid administration in hospitals.

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Guest, Charlotte; Sobotka, Fabian; Karavasopoulou, Athina; Ward, Stephen; Bantel, Carsten

2017-01-01

Pain remains insufficiently treated in hospitals. Increasing evidence suggests human factors contribute to this, due to nurses failing to administer opioids. This behavior might be the consequence of nurses' mental models about opioids. As personal experience and conceptions shape these models, the aim of this prospective survey was to identify model-influencing factors. A questionnaire was developed comprising of 14 statements concerning ideations about opioids and seven questions concerning demographics, indicators of adult learning, and strength of religious beliefs. Latent variables that may underlie nurses' mental models were identified using undirected graphical dependence models. Representative items of latent variables were employed for ordinal regression analysis. Questionnaires were distributed to 1,379 nurses in two London, UK, hospitals (n=580) and one German (n=799) hospital between September 2014 and February 2015. A total of 511 (37.1%) questionnaires were returned. Mean (standard deviation) age of participants were 37 (11) years; 83.5% participants were female; 45.2% worked in critical care; and 51.5% had more than 10 years experience. Of the nurses, 84% were not scared of opioids, 87% did not regard opioids as drugs to help patients die, and 72% did not view them as drugs of abuse. More English (41%) than German (28%) nurses were afraid of criminal investigations and were constantly aware of side effects (UK, 94%; Germany, 38%) when using opioids. Four latent variables were identified which likely influence nurses' mental models: "conscious decision-making"; "medication-related fears"; "practice-based observations"; and "risk assessment". They were predicted by strength of religious beliefs and indicators of informal learning such as experience but not by indicators of formal learning such as conference attendance. Nurses in both countries employ analytical and affective mental models when administering the opioids and seem to learn from experience

[Bedside implantation of a new temporary vena cava inferior filter : German results from the European ANGEL registry].

Science.gov (United States)

Baumann, S; Becher, T; Giannakopoulos, K; Jabbour, C; Fastner, C; El-Battrawy, I; Ansari, U; Lossnitzer, D; Behnes, M; Alonso, A; Kirschning, T; Dissmann, R; Kueck, O; Stern, D; Michels, G; Borggrefe, M; Akin, I

2018-04-01

Pulmonary embolism (PE) is a frequently occurring complication in critically ill patients, and the simultaneous occurrence of PE and life-threatening bleeding is a therapeutic dilemma. Inferior vena cava filters (IVCF) may represent an important therapeutic alternative in these cases. The Angel® catheter (Bio2 Medical Inc., San Antonio, TX, USA) is a novel IVCF that provides temporary protection from PE and is implanted at bedside without fluoroscopy. The European Angel® Catheter Registry is an observational, multicenter study. In our German substudy, we investigated patients from three German hospitals and four intensive care units, who underwent Angel® catheter implantation between February 2016 and December 2016. A total of 23 critically ill patients (68 ± 9 years, 43% male) were included. The main indication for implantation was a high risk for or an established PE, combined with contraindications for prophylactic or therapeutic anticoagulation due to either an increased risk of bleeding (81%) or active bleeding (13%). The Angel® catheter was successfully inserted in all patients at bedside. No PE occurred in patients with an indwelling Angel® catheter. Clots with a diameter larger the 20 mm, indicating clot migration, were detected in 5% of the patients by cavography before filter retrieval. Filter retrieval was uneventful in all of our cases, while filter dislocation occurred in 3% of the patients. The German data from the multicenter European Angel® Catheter Registry show that the Angel® catheter is a safe and effective approach for critically ill patients with a high risk for the development of PE or an established PE, when an anticoagulation therapy is contraindicated.

Main results of the german risk study, phase B

International Nuclear Information System (INIS)

Heuser, F.W.

1988-01-01

Work on the German Risk Study is under contract of the Federal Ministry of Research and Technology. The reference plant for the analysis is the Biblis nuclear power plant, Unit B, a KWU pressurized water reactor of the 1300 MWel class. The plant is in operation since 1976. First results on Phase A of the study have been published in 1979. Investigations on Phase B have been foreseen to endeepen the analysis. The principal purpose of these investigations is to improve and to optimize the plant's safety features on a more realistic basis. Main objectives of Phase B are: - Completeness of accident event tree analysis taking into account further accident initiating events. - Identification and analyses of accident management measures which are adequate to minimize accidental risk. - improvement of the analysis on an as far as possible realistic basis, thereby taking into account recent results of safety research. The paper deals with the most important results of the plant analyses (level 1 and level 2) which have been performed within the scope of Phases B of the study

German Studies in America. German Studies Notes.

Science.gov (United States)

Sander, Volkmar; Osterle, Heinz D.

This volume contains two papers, "German Studies in America," by Volkmar Sander, and "Historicism, Marxism, Structuralism: Ideas for German Culture Courses," by Heinz D. Osterle. The first paper discusses the position of German studies in the United States today. The greatest challenge comes from low enrollments; therefore,…

[Orthopedic and trauma surgery in the German-DRG-System 2009].

Science.gov (United States)

Franz, D; Windolf, J; Siebert, C H; Roeder, N

2009-01-01

The German DRG-System was advanced into version 2009. For orthopedic and trauma surgery significant changes concerning coding of diagnoses, medical procedures and concerning the DRG-structure were made. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2008 and 2009 based on the publications of the German DRG-institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2009 focussed on the development of DRG-structure, DRG-validation and codes for medical procedures to be used for very complex cases. The outcome of these changes for German hospitals may vary depending in the range of activities. G-DRG-System gained complexity again. High demands are made on correct and complete coding of complex orthopedic and trauma surgery cases. Quality of case-allocation within the G-DRG-System was improved. Nevertheless, further adjustments of the G-DRG-System especially for cases with severe injuries are necessary.

East German medical aid to Nicaragua: the politics of solidarity between biomedicine and primary health care

Directory of Open Access Journals (Sweden)

Iris Borowy

Full Text Available Abstract Between 1979 and 1989 the government of the German Democratic Republic provided health assistance to Sandinista Nicaragua. After initial relief aid, the Sandinista embrace of a primary health care-based health system made East German health support difficult. The non-convertible currency, the repressive quality of the East German leadership, and the lack of experience with primary health care processes all limited its potential to provide support. After 1985, when implementation of this system stalled, East German health assistance was revitalized with the donation of the Hospital Carlos Marx. Providing medical services to three hundred thousand people, it combined elements of a strictly East German institution, using German personnel and equipment, with some integration into local systems.

[Meeting the needs of the European working time directive in german medical profession].

Science.gov (United States)

Friedrich, M; Popov, A F; Schmitto, J D; Bireta, C; Emmert, A; Tirilomis, T

2011-06-01

The legal obligation of the European Working Time Directive with its implementation into a German Working Hours Act requires German hospitals to give up old structures and requires the implementation of new working time models. The failure of the revision of the European Working Time Directive in April 2009 prevented that any changes of status quo might happen in the near future. Fundamental terms of the working law for the medical area have been elucidated and have been implemented into concrete calculation formulas. The planned working time has been clearly determined. Particularly, on-call duties and a signed "OptOut-declaration" have huge effects on the upper limit of the working time that is to be determined. Shift duty leads to the greatest limitations of the upper limit of the working time. The Working Hours Act defines the maximal, available, individual working time budget and thus the working time budget of a hospital and it limits the maximal availability of the service providers of a hospital as well as defining the maximal personnel costs. Transparency in this area lays the foundation for an effective time management and the creation of new working time models in accordance with the European Working Time Directive as well as the Working Hours Act and the "TVÄ" (labour contract for doctors at municipal hospitals). It is possible, with the knowledge of the maximal working time budget and the thereof resulting personnel costs, to calculate the economical revenues better. The reallocation of the working time of doctors enables efficiency enhancement. It is necessary to demand a clear definition of the tasks of doctors with the consequential discharge of tasks that should not/do not belong to the responsibilities of a doctor. This would lead to a more attractive working environment for doctors at hospitals and thus to an improvement of the care of the patients. The implementation of the European Time Directive is not to be seen as unrealizable, as has been

Emission of biocides from hospitals: comparing current survey results with European Union default values.

Science.gov (United States)

Tluczkiewicz, Inga; Bitsch, Annette; Hahn, Stefan; Hahn, Torsten

2010-04-01

Under the European Union (EU) Biocidal Products Directive 98/8/EC, comprehensive evaluations on substances of the Third Priority List were conducted until 31 July 2007. This list includes, among other categories, disinfectants for human hygiene (e.g., skin and surface disinfection). For environmental exposure assessment of biocides, the EU emission scenarios apply. Currently available default values for disinfectants are based on consumption data from not more than 8 hospitals and were originally assembled for other purposes. To revalidate these default values, a survey on annual consumption data was performed in 27 German hospitals. These data were analyzed to provide consumption data per bed and day and per nurse and day for particular categories of active ingredients and were compared with default values from the EU emission scenario documents. Although several deviations were detected, an overall acceptable correspondence between Emission Scenario Documents default values and the current survey data was found. (c) 2009 SETAC

… but You Are Not German." -- Afro-German Culture and Literature in the German Language Classroom

Science.gov (United States)

Schenker, Theresa; Munro, Robert

2016-01-01

Units and classes dedicated to multiculturalism in Germany have predominantly focused on Turkish-German literature and culture. Afro-Germans have been a minority whose culture and literature have only marginally been included in German classes, even though Afro-Germans have been a part of Germany for centuries and have undergone efforts at…

Toxicity of Cypermethrin and Chlorpyrifos Against German Cockroach [ Blattella germanica (Blattaria: Blattellidae)] Strains from Hamadan, Iran.

Science.gov (United States)

Nazari, Mansour; Motlagh, Behrouz Alipourian; Nasirian, Hassan

German cockroach has relatively short life cycle and reproduce rapidly. It is the most common medically and public health pest. As a result, it is essential to combat this pest. Cypermethrin and chlorpyrifos are used by private companies in Hamadan to control Blattella germanica. It seems necessary to determine its susceptibility levels to these insecticides. The aim of this study was to determine the susceptibility levels of B. germanica strains to cypermethrin and chlorpyrifos in Hamadan. In this study, the German cockroach strains were collected from two hospitals (Fatemiyeh and Atiyeh) in Hamadan and transfered to the insectarium. The cockroach strains were reared under the same laboratory condition. Then their sensitivity levels were considered to 1, 2, 4, 8 and 16 mg m -2 for cypermethrin and 0.82, 1.65, 3.31, 6.63, 9.945 and 13.26 mg m -2 for chlorpyrifos using surface contact method. Results based on insecticide treated doses, B. germanica strains showed different percent mortality to the insecticides ranged from 13.3-100. The LD 50 and LD 90 and regression lines of the treated insecticides against German cockroach strains indicate that Fatemiyeh Hospital strain is more susceptible to the treated insecticides than Atiyeh Hospital strain. The LD 50 and LD 90 of chlorpyrifos are also lower than cypermethrin, indicated that chlorpyrifos is more effective than cypermethrin against German cockroach. As the slopes of the regression lines are observed mild in this study indicate that the population of the cockroach strains is very heterogeneous. It can be a symbol of insecticides resistance to cypermethrin and chlorpyrifos. As chlorpyrifos and cypermethrin insecticides are also used for residual spraying by private companies and the doses which provide more than 90% mortality are below the WHO recommended insecticide doses. Therefore, chlorpyrifos and cypermethrin insecticides can be used for B. germanica control in Hamadan within regular monitoring and preventive

Quantification of ETS exposure in hospitality workers who have never smoked.

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Kolb, Stefanie; Brückner, Ulrike; Nowak, Dennis; Radon, Katja

2010-08-12

Environmental Tobacco Smoke (ETS) was classified as human carcinogen (K1) by the German Research Council in 1998. According to epidemiological studies, the relative risk especially for lung cancer might be twice as high in persons who have never smoked but who are in the highest exposure category, for example hospitality workers. In order to implement these results in the German regulations on occupational illnesses, a valid method is needed to retrospectively assess the cumulative ETS exposure in the hospitality environment. A literature-based review was carried out to locate a method that can be used for the German hospitality sector. Studies assessing ETS exposure using biological markers (for example urinary cotinine, DNA adducts) or questionnaires were excluded. Biological markers are not considered relevant as they assess exposure only over the last hours, weeks or months. Self-reported exposure based on questionnaires also does not seem adequate for medico-legal purposes. Therefore, retrospective exposure assessment should be based on mathematical models to approximate past exposure. For this purpose a validated model developed by Repace and Lowrey was considered appropriate. It offers the possibility of retrospectively assessing exposure with existing parameters (such as environmental dimensions, average number of smokers, ventilation characteristics and duration of exposure). The relative risk of lung cancer can then be estimated based on the individual cumulative exposure of the worker. In conclusion, having adapted it to the German hospitality sector, an existing mathematical model appears to be capable of approximating the cumulative exposure. However, the level of uncertainty of these approximations has to be taken into account, especially for diseases with a long latency period such as lung cancer.

Marlene Dietrich in the German Classroom: A German Film Project--Humanities through the Golden Age of German Cinema.

Science.gov (United States)

Flippo, Hyde

1993-01-01

Marlene Dietrich and other classic performers of German cinema can serve to open up a whole new realm for students of German, at secondary and postsecondary levels. By researching and viewing German and American film classics, students have opportunity to learn more about German language and an important element of German culture that has had…

Microsatellite Instability Occurs Rarely in Patients with Cholangiocarcinoma: A Retrospective Study from a German Tertiary Care Hospital

Directory of Open Access Journals (Sweden)

Ria Winkelmann

2018-05-01

Full Text Available Immune-modulating therapy is a promising therapy for patients with cholangiocarcinoma (CCA. Microsatellite instability (MSI might be a favorable predictor for treatment response, but comprehensive data on the prevalence of MSI in CCA are missing. The aim of the current study was to determine the prevalence of MSI in a German tertiary care hospital. Formalin-fixed paraffin-embedded tissue samples, obtained in the study period from 2007 to 2015 from patients with CCA undergoing surgical resection with curative intention at Johann Wolfgang Goethe University hospital, were examined. All samples were investigated immunohistochemically for the presence of MSI (expression of MLH1, PMS2, MSH2, and MSH6 as well as by pentaplex polymerase chain reaction for five quasimonomorphic mononucleotide repeats (BAT-25, BAT-26, NR-21, NR-22, and NR-24. In total, 102 patients were included, presenting intrahepatic (n = 35, 34.3%, perihilar (n = 42, 41.2%, and distal CCA (n = 25, 24.5%. In the immunohistochemical analysis, no loss of expression of DNA repair enzymes was observed. In the PCR-based analysis, one out of 102 patients was found to be MSI-high and one out of 102 was found to be MSI-low. Thus, MSI seems to appear rarely in CCA in Germany. This should be considered when planning immune-modulating therapy trials for patients with CCA.

Intelligibility of Standard German and Low German to Speakers of Dutch

NARCIS (Netherlands)

Gooskens, C.S.; Kürschner, Sebastian; van Bezooijen, R.

2011-01-01

This paper reports on the intelligibility of spoken Low German and Standard German for speakers of Dutch. Two aspects are considered. First, the relative potential for intelligibility of the Low German variety of Bremen and the High German variety of Modern Standard German for speakers of Dutch is

Control beliefs and health locus of control in Ugandan, German and migrated sub-Saharan African HIV infected individuals.

Science.gov (United States)

Milz, Ruth U; Husstedt, Ingo-W; Reichelt, Doris; Evers, Stefan

2016-04-01

Little is known about the influence of control beliefs on antiretroviral drug adherence in patients who migrated from sub-Saharan Africa to Europe. The aim of this study was to explore the differences in health locus of control and control beliefs between HIV infected patients from sub-Saharan Africa with and without a lifetime experience of migration. A sample of 62 HIV infected consecutive patients referred to the HIV clinics at the University Hospital of Münster (Germany) and at the Rubaga Hospital Kampala (Uganda) were enrolled into this study. We compared three groups of patients: sub-Saharan African migrants, German patients, and local Ugandan patients. We used the German health and illness related control beliefs questionnaire (KKG), the Competence and control beliefs questionnaire (FKK), and the Powe Fatalism Inventory-HIV/AIDS-Version (PFI-HIV/AIDS-Version) and translated these scales into English and Luganda. In addition, the patients' sociodemographic, acculturation, clinical, and immunological data were registered. Significant results were shown in HIV related external locus of control between migrated sub-Saharan African and local Ugandan patients compared to German patients. General control beliefs showed no significant differences. In the PFI-HIV-Version, there was a significant difference between migrated sub-Saharan African and Ugandan patients compared to German patients. Our data suggest that the experience of migration does not influence the locus of control. Compared to German HIV patients, African patients in general showed a significantly higher external health locus of control which might have implications for drug adherence. Copyright © 2016 Elsevier Inc. All rights reserved.

Editor's Choice - High Annual Hospital Volume is Associated with Decreased in Hospital Mortality and Complication Rates Following Treatment of Abdominal Aortic Aneurysms: Secondary Data Analysis of the Nationwide German DRG Statistics from 2005 to 2013.

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Trenner, Matthias; Kuehnl, Andreas; Salvermoser, Michael; Reutersberg, Benedikt; Geisbuesch, Sarah; Schmid, Volker; Eckstein, Hans-Henning

2018-02-01

The aim of this study was to analyse the association between annual hospital procedural volume and post-operative outcomes following repair of abdominal aortic aneurysms (AAA) in Germany. Data were extracted from nationwide Diagnosis Related Group (DRG) statistics provided by the German Federal Statistical Office. Cases with a diagnosis of AAA (ICD-10 GM I71.3, I71.4) and procedure codes for endovascular aortic repair (EVAR; OPS 5-38a.1*) or open aortic repair (OAR; OPS 5-38.45, 5-38.47) treated between 2005 and 2013 were included. Hospitals were empirically grouped to quartiles depending on the overall annual volume of AAA procedures. A multilevel multivariable regression model was applied to adjust for sex, medical risk, type of procedure, and type of admission. Primary outcome was in hospital mortality. Secondary outcomes were complications, use of blood products, and length of stay (LOS). The association between AAA volume and in hospital mortality was also estimated as a function of continuous volume. A total of 96,426 cases, of which 11,795 (12.6%) presented as ruptured (r)AAA, were treated in >700 hospitals (annual median: 501). The crude in hospital mortality was 3.3% after intact (i)AAA repair (OAR 5.3%; EVAR 1.7%). Volume was inversely associated with mortality after OAR and EVAR. Complication rates, LOS, and use of blood products were lower in high volume hospitals. After rAAA repair, crude mortality was 40.4% (OAR 43.2%; EVAR 27.4%). An inverse association between mortality and volume was shown for rAAA repair; the same accounts for the use of blood products. When considering volume as a continuous variate, an annual caseload of 75-100 elective cases was associated with the lowest mortality risk. In hospital mortality and complication rates following AAA repair are inversely associated with annual hospital volume. The use of blood products and the LOS are lower in high volume hospitals. A minimum annual case threshold for AAA procedures might improve

Satisfaction with rehabilitative health care services among German and non-German nationals residing in Germany: a cross-sectional study.

Science.gov (United States)

Brzoska, Patrick; Sauzet, Odile; Yilmaz-Aslan, Yüce; Widera, Teresia; Razum, Oliver

2017-08-11

Rehabilitation following medical conditions is largely offered as in-patient service in Germany. Foreign-national residents use rehabilitative services less often than Germans and attain less favourable treatment outcomes. These differences are independent of demographic, socioeconomic and health characteristics. Satisfaction with different aspects of rehabilitative care presumably affects the effectiveness of rehabilitative services. We compared the degree of satisfaction with different domains of the rehabilitative care process between Germans and non-German nationals residing in Germany. We used data from a cross-sectional rehabilitation patient survey annually conducted by the German Statutory Pension Insurance Scheme. The sample comprises 274 513 individuals undergoing medical rehabilitation in 642 hospitals during the years 2007-2011. Participants rated their satisfaction with different domains of rehabilitation on multi-item scales. We dichotomised each scale to low/moderate and high satisfaction. For each domain, a multilevel adjusted logistic regression analysis was conducted to examine differences in the levels of satisfaction between German and non-German nationals. Average marginal effects (AMEs) and 99.5% CI were computed as effect estimates. AMEs represent differences in the probability for the occurrence of the outcome. Turkish nationals had a higher probability for being less satisfied with most aspects of their rehabilitation, with AMEs ranging between 0.05 (99.5% CI 0.00 to 0.09) for 'satisfaction with psychological care' and 0.11 (99.5% CI 0.08 to 0.14) for 'satisfaction with treatments during rehabilitation'. Patients from former Yugoslavia and from Portugal/Spain/Italy/Greece were as satisfied as Germans with most aspects of their rehabilitation. Turkish nationals are less satisfied with their rehabilitative care than other population groups. This may be attributable to the diversity of the population in terms of its expectations towards

Evaluation of results of Phase B of the German Risk Study for Nuclear Power Plants

International Nuclear Information System (INIS)

Fischer, B.; Hahn, L.; Sailer, M.

1989-01-01

The expert opinion summarizes and discusses the intermediate and the final results of Phase B of the German Risk Study. Emphasis is placed on systems analyses and event scenarios, core melt-down scenarios and effects on the containment, failure of the containment and resulting source terms, radioactivity transport and consequences of accidents, multi-system emergencies and external disturbances, accident management and means of mitigation of damage. (DG) [de

How do German bilingual schoolchildren process German prepositions? - A study on language-motor interactions.

Science.gov (United States)

Ahlberg, Daniela Katharina; Bischoff, Heike; Strozyk, Jessica Vanessa; Bryant, Doreen; Kaup, Barbara

2018-01-01

While much support is found for embodied language processing in a first language (L1), evidence for embodiment in second language (L2) processing is rather sparse. In a recent study, we found support for L2 embodiment, but also an influence of L1 on L2 processing in adult learners. In the present study, we compared bilingual schoolchildren who speak German as one of their languages with monolingual German schoolchildren. We presented the German prepositions auf (on), über (above), and unter (under) in a Stroop-like task. Upward or downward responses were made depending on the font colour, resulting in compatible and incompatible trials. We found compatibility effects for all children, but in contrast to the adult sample, there were no processing differences between the children depending on the nature of their other language, suggesting that the processing of German prepositions of bilingual children is embodied in a similar way as in monolingual German children.

[Commentary by the German Society for Thoracic and Cardiovascular Surgery on the positions statement by the German Cardiology Society on quality criteria for transcatheter aortic valve implantation (TAVI)].

Science.gov (United States)

Cremer, Jochen; Heinemann, Markus K; Mohr, Friedrich Wilhelm; Diegeler, Anno; Beyersdorf, Friedhelm; Niehaus, Heidi; Ensminger, Stephan; Schlensak, Christian; Reichenspurner, Hermann; Rastan, Ardawan; Trummer, Georg; Walther, Thomas; Lange, Rüdiger; Falk, Volkmar; Beckmann, Andreas; Welz, Armin

2014-12-01

Surgical aortic valve replacement is still considered the first-line treatment for patients suffering from severe aortic valve stenosis. In recent years, transcatheter aortic valve implantation (TAVI) has emerged as an alternative for selected high-risk patients. According to the latest results of the German external quality assurance program, mandatory by law, the initially very high mortality and procedural morbidity have now decreased to approximately 6 and 12%, respectively. Especially in Germany, the number of patients treated by TAVI has increased exponentially. In 2013, a total of 10.602 TAVI procedures were performed. TAVI is claimed to be minimally invasive. This is true concerning the access, but it does not describe the genuine complexity of the procedure, defined by the close neighborhood of the aortic valve to delicate intracardiac structures. Hence, significant numbers of life-threatening complications may occur and have been reported. Owing to the complexity of TAVI, there is a unanimous concordance between cardiologists and cardiac surgeons in the Western world demanding a close heart team approach for patient selection, intervention, handling of complications, and pre- as well as postprocedural care, respectively. The prerequisite is that TAVI should not be performed in centers with no cardiac surgery on site. This is emphasized in all international joint guidelines and expert consensus statements. Today, a small number of patients undergo TAVI procedures in German hospitals without a department of cardiac surgery on site. To be noted, most of these hospitals perform less than 20 cases per year. Recently, the German Cardiac Society (DGK) published a position paper supporting this practice pattern. Contrary to this statement and concerned about the safety of patients treated this way, the German Society for Thoracic and Cardiovascular Surgery (DGTHG) still fully endorses the European (ESC/EACTS) and other actual international guidelines and

[Consistency and Reliability of MDK Expertise Examining the Encoding in the German DRG System].

Science.gov (United States)

Gaertner, T; Lehr, F; Blum, B; van Essen, J

2015-09-01

Hospital inpatient stays are reimbursed on the basis of German diagnosis-related groups (G-DRG). The G-DRG classification system is based on complex coding guidelines. The Medical Review Board of the Statutory Health Insurance Funds (MDK) examines the encoding by hospitals and delivers individual expertises on behalf of the German statutory health insurance companies in cases in which irregularities are suspected. A study was conducted on the inter-rater reliability of the MDK expertises regarding the scope of the assessment. A representative sample of 212 MDK expertises was taken from a selected pool of 1 392 MDK expertises in May 2013. This representative sample underwent a double-examination by 2 independent MDK experts using a special software based on the 3MTM G-DRG Grouper 2013 of 3M Medica, Germany. The following items encoded by the hospitals were examined: DRG, principal diagnosis, secondary diagnoses, procedures and additional payments. It was analysed whether the results of MDK expertises were consistent, reliable and correct. 202 expertises were eligible for evaluation, containing a total of 254 questions regarding one or more of the 5 items encoded by hospitals. The double-examination by 2 independent MDK experts showed matching results in 187 questions (73.6%) meaning they had been examined consistently and correctly. 59 questions (23.2%) did not show matching results, nevertheless they had been examined correctly regarding the scope of the assessment. None of the principal diagnoses was significantly affected by inconsistent or wrong judgment. A representative sample of MDK expertises examining the DRG encoding by hospitals showed a very high percentage of correct examination by the MDK experts. Identical MDK expertises cannot be achieved in all cases due to the scope of the assessment. Further improvement and simplification of codes and coding guidelines are required to reduce the scope of assessment with regard to correct DRG encoding and its

[King's Parkinson's disease pain scale : Intercultural adaptation in the German language].

Science.gov (United States)

Jost, W H; Rizos, A; Odin, P; Löhle, M; Storch, A

2018-02-01

Pain is a frequent symptom of idiopathic Parkinson's disease and has a substantial impact on quality of life. The King's Parkinson's disease pain scale (KPPS) has become internationally established and is an English-language, standardized, reliable and valid scale for evaluation of pain in idiopathic Parkinson's disease. This article presents a validated version in German. The German translation was adapted interculturally and developed using an internationally recognized procedure in consultation with the authors of the original publication. The primary text was first translated by two bilingual neuroscientists independently of one another. Thereafter, the two versions were collated to generate a consensus version, which was accepted by the translators and preliminarily trialled with 10 patients. Hereafter, the German version was re-translated back into English by two other neurologists, again independently of one another, and a final consensus was agreed on using these versions. This English version was then compared with the original text by all of the translators, a process which entailed as many linguistic modifications to the German version as the translators considered necessary to generate a linguistically acceptable German version that was as similar as possible to the original English version. After this test text had been subsequently approved by the authors, the German text was applied to 50 patients in two hospitals, and reviewed as to its practicability and comprehensibility. This work led to the successful creation of an inter-culturally adapted and linguistically validated German version of the KPPS. The German version presented here is a useful scare for recording and quantifying pain in empirical studies, as well as in clinical practice.

Translation and validation of the German version of the Mother-Generated Index and its application during the postnatal period.

Science.gov (United States)

Grylka-Baeschlin, Susanne; van Teijlingen, Edwin; Stoll, Kathrin; Gross, Mechthild M

2015-01-01

the Mother-Generated Index (MGI) is a validated tool to assess postnatal quality of life. It is usually administered several weeks or months after birth and correlates with indices of post partum mood states and physical complaints. The instrument had not been translated into German before or validated for use among German-speaking women, nor have the results of the tool been assessed specifically for the administration directly after birth. This paper aims to describe the systematic translation process of the MGI into German and to assess the convergent validity of the German version of the instrument directly after birth and seven weeks post partum. prospective two-stage survey. two rural hospitals in the south of Germany and in the north of Switzerland. all women giving birth between 1st October and 15th December 2012 with sufficient knowledge of German and whose babies were not referred to a neonatal care unit; 226 women were eligible to participate. two questionnaires including questions relating to socio-demographic factors and perinatal care, and incorporating the MGI, the Hospital Anxiety and Depression Scale (HADS) and the Postnatal Morbidity Index (PMI). All instruments were subjected to forward and back translation and pilot-tested; the first questionnaire was then administered in the first two days after birth and the second six weeks post partum. Parametric and non-parametric tests were computed using SPSS. 129 surveys were returned an average of three days after birth and 83 after seven weeks. Higher postnatal quality of life showed a significant correlation with a lower anxiety and depression score (pGerman version of the MGI is a valid indicator of physical and emotional post partum well-being. the German version of the MGI can be used in the post partum period to identify women whose quality of life is impaired during the first days after birth, in order to initiate extended midwifery care and referral if necessary. Copyright © 2014 The Authors

The German carbide program: Performance, experimental findings, and evaluation of irradiation results

International Nuclear Information System (INIS)

Steiner, H.; Freund, D.; Geithoff, D.

1982-09-01

In this report a synopsis of the German carbide program is presented. The program comprises the irradiation of about 100 carbide pins equipped with pelletted fuel. Most of these fuel pins were He-bonded, the sodium bonding concept taken as a back-up solution. The main design parameters such as smear and pellet density, gap size, pin diameter and wall thickness as well as the irradiation conditions were varied mostly within wide ranges. Based on a compilation of relevant pin parameters, irradiation conditions, and the results of various irradiation experiments conclusions on the optimum ranges of the main design parameters are drawn. Furthermore, some important aspects of fuel pin behaviour are discussed based on quantitative results from post irradiation examinations. (orig.) [de

The German model of capitalism and the persistence of outward foreign direct investment: evidence from German manufacturing industries

Directory of Open Access Journals (Sweden)

Martin T Bohl

2011-06-01

Full Text Available Against the backdrop of critique on the German model of capitalism in general, and German public policy in particular as to the ability to successfully adjust to rapid change and exogenous shocks in wake of economic globalisation, this paper investigates the degree of shock persistence in foreign direct investment (FDI of ten German manufacturing industries for the period 1976 to 2003. Theory on exports and non-FDI investment suggests that FDI should exhibit a considerable degree of shock persistence because they are subject to high sunk costs because of high entry and exit costs associated with the high level of asset specificity that is normally connected to FDI. Persistence in foreign direct investment time series data is established by applying various unit root tests. The results are robust to the potential presence of structural breaks in the data. The empirical analysis shows that German outward FDI in mature manufacturing industries, with one exception, exhibits a high degree of shock persistence. The results suggest, at least for mature German industries, that the sunk costs view on shock persistency is confirmed for outward FDI. The results furnish evidence for a tentative assessment of the relationship between German public policy and FDI strategies of multinational firms.

Rare earth germanates

International Nuclear Information System (INIS)

Bondar', I.A.; Vinogradova, N.V.; Dem'yanets, L.N.

1983-01-01

Rare earth germanates attract close attention both as an independent class of compounds and analogues of a widely spread class of natural and synthetic minerals. The methods of rare earth germanate synthesis (solid-phase, hydrothermal) are considered. Systems on the basis of germanium and rare earth oxides, phase diagrams, phase transformations are studied. Using different chemical analysese the processes of rare earth germanate formation are investigated. IR spectra of alkali and rare earth metal germanates are presented, their comparative analysis being carried out. Crystal structures of the compounds, lattice parameters are studied. Fields of possible application of rare earth germanates are shown

Rare earth germanates

International Nuclear Information System (INIS)

Bondar', I.A.; Vinogradova, N.V.; Dem'yanets, L.N.

1983-01-01

From the viewpoint of structural chemistry and general regularities controlling formation reactions of compounds and phases in melts, solid and gaseous states, recent achievements in the chemistry of rare earth germanates are generalized. Methods of synthesizing germanates, systems on the base of germanium oxides and rare earths are considered. The data on crystallochemical characteristics are tabulated. Individual compounds of scandium germanate are also characterized. Processes of germanate formation using the data of IR-spectroscopy, X-ray phase analysis are studied. The structure and morphotropic series of rare earth germanates and silicates are determined. Fields of their present and possible future application are considered

[Competition between hospitals--from a legal perspective].

Science.gov (United States)

Bohle, Thomas

2009-01-01

Competition between hospitals exists in many different fields. In legal terms this competition is shaped by disputes over the status of "hospitals forming part of the Hospital Plan" (Plankrankenhaus). The German Federal Constitutional Court's ruling of January 14, 2004 granted hospital authorities the right of action for unfair competition. According to the Federal Administrative Court's ruling of September 25, 2008, however, third-party protection is limited to cases where the hospital filing the suit has itself unsuccessfully applied for inclusion in the state-level hospitals plan for the market segment served by the accepted hospital. In contrast, action that merely challenges an unfair preference of a competitor will remain inadmissible. Third-party protection between hospitals is also under way in the field of "Integrated Healthcare" (Integrierte Versorgung) (Sect. 140a et seqq. Book V of the German Social Security Code-SGB V): in the case of ECJ C-300/07 on December 16, 2008 (Oymanns/AOK Rheinland & Hamburg) the Advocate General in his final submissions not only expressed the opinion that the statutory health insurance funds are contract-placing authorities, but also argued that integration contracts are public orders. If the European Court of Justice (ECJ) takes the Advocate General's view, future integration contracts will become subject to the regulations governing public orders and thus also subject to the relevant verification procedure.

How do German bilingual schoolchildren process German prepositions? – A study on language-motor interactions

Science.gov (United States)

Bischoff, Heike; Strozyk, Jessica Vanessa; Bryant, Doreen; Kaup, Barbara

2018-01-01

While much support is found for embodied language processing in a first language (L1), evidence for embodiment in second language (L2) processing is rather sparse. In a recent study, we found support for L2 embodiment, but also an influence of L1 on L2 processing in adult learners. In the present study, we compared bilingual schoolchildren who speak German as one of their languages with monolingual German schoolchildren. We presented the German prepositions auf (on), über (above), and unter (under) in a Stroop-like task. Upward or downward responses were made depending on the font colour, resulting in compatible and incompatible trials. We found compatibility effects for all children, but in contrast to the adult sample, there were no processing differences between the children depending on the nature of their other language, suggesting that the processing of German prepositions of bilingual children is embodied in a similar way as in monolingual German children. PMID:29538404

German Business in Russia

Directory of Open Access Journals (Sweden)

Irakliy D. Gvazava

2013-01-01

Full Text Available Since Perestroika German-Russian relationships have been steadily developing fueled by close contacts between the leaders of both countries. Boris Yeltsin and Helmut Kohl, Vladimir Putin and Gerhard Schröder, Dmitry Medvedev and Angela Merkel had friendly relations resulted in some fruitful business projects, intergovernmental economic forums etc. In my article I will consider the activities of German companies in Russia, advantages, barriers and expectations

Teaching German-Americana

Science.gov (United States)

Tolzmann, Don Heinrich

1976-01-01

A university course entitled "The German-Americans" attempted to study and evaluate German culture in the U. S. Lecture topics and term paper theses are listed and a selected annotated bibliography of German-American culture is included. (CHK)

The German Quality Network Sepsis: study protocol for the evaluation of a quality collaborative on decreasing sepsis-related mortality in a quasi-experimental difference-in-differences design.

Science.gov (United States)

Schwarzkopf, Daniel; Rüddel, Hendrik; Gründling, Matthias; Putensen, Christian; Reinhart, Konrad

2018-01-18

While sepsis-related mortality decreased substantially in other developed countries, mortality of severe sepsis remained as high as 44% in Germany. A recent German cluster randomized trial was not able to improve guideline adherence and decrease sepsis-related mortality within the participating hospitals, partly based on lacking support by hospital management and lacking resources for documentation of prospective data. Thus, more pragmatic approaches are needed to improve quality of sepsis care in Germany. The primary objective of the study is to decrease sepsis-related hospital mortality within a quality collaborative relying on claims data. The German Quality Network Sepsis (GQNS) is a quality collaborative involving 75 hospitals. This study protocol describes the conduction and evaluation of the start-up period of the GQNS running from March 2016 to August 2018. Democratic structures assure participatory action, a study coordination bureau provides central support and resources, and local interdisciplinary quality improvement teams implement changes within the participating hospitals. Quarterly quality reports focusing on risk-adjusted hospital mortality in cases with sepsis based on claims data are provided. Hospitals committed to publish their individual risk-adjusted mortality compared to the German average. A complex risk-model is used to control for differences in patient-related risk factors. Hospitals are encouraged to implement a bundle of interventions, e.g., interdisciplinary case analyses, external peer-reviews, hospital-wide staff education, and implementation of rapid response teams. The effectiveness of the GQNS is evaluated in a quasi-experimental difference-in-differences design by comparing the change of hospital mortality of cases with sepsis with organ dysfunction from a retrospective baseline period (January 2014 to December 2015) and the intervention period (April 2016 to March 2018) between the participating hospitals and all other German

Regular and problematic leisure-time Internet use in the community: results from a German population-based survey

OpenAIRE

Beutel, ME; Brähler, E; Glaesmer, H; Kuss, DJ; Wölfling, K; Müller, KW

2011-01-01

In our study, we attempted to identify systematically the use of Internet applications in the German population in order to derive risk factors for problematic use. In a representative survey of the German population, we queried 1,401 women and 1,111 men between the ages of 14 and 94 years by specific questions and standardized questionnaires on depression, anxiety (HADS), and depersonalization (CDS-2). The majority of the German population (55%) used the Internet in their leisure time. Users...

[Required Framework for the Collection of Real-life Data: An Example from University Eye Hospital Munich].

Science.gov (United States)

Kortüm, Karsten; Kern, Christoph; Meyer, Gerhard; Priglinger, Siegfried; Hirneiß, Christoph

2017-12-01

Background The importance of evaluating real-life data is constantly increasing. Currently available computer systems better allow for analyses of data, as more and more data is available in a digital form. Before a project for real-life data analyses is started, technical considerations and staff, legal, and data protection procedures need to be addressed. In this manuscript, experiences made at the University Eye Hospital in Munich will be shared. Materials and Methods Legal requirements, as found in laws and guidelines governing documentation and data privacy, are highlighted. Technical requirements for information technology infrastructure and software are defined. A survey conducted by the German Ophthalmological Society, among German eye hospitals investigating the current state of digitalization, was conducted. Also, staff requirements are outlined. Results A database comprising results of 330,801 patients was set up. It includes all diagnoses, procedures, clinical findings and results from diagnostic devices. This database was approved by the local data protection officer. In less than half of German eye hospitals (n = 21) that participated in the survey (n = 54), a complete electronic documentation is done. Fourteen institutions are completely paper-based, and the remainder of the hospitals used a mixed system. Conclusion In this work, we examined the framework that is required to develop a comprehensive database containing real-life data from clinics. In future, these databases will become increasingly important as more and more innovation are made in decision support systems. The base for this is comprehensive and well-curated databases. Georg Thieme Verlag KG Stuttgart · New York.

Workload and quality of life of surgeons. Results and implications of a large-scale survey by the German Society of Surgery.

Science.gov (United States)

Bohrer, Thomas; Koller, Michael; Schlitt, Hans Juergen; Bauer, Hartwig

2011-06-01

Quality of life is of vital importance for patients undergoing surgery. However, little is known about the quality of life of surgeons who are facing a stressful and dramatically changing working environment. For this reason, this large-scale study investigated the quality of life (QL) of surgeons in Germany in the context of occupational, private, and system-related risk factors. The study population consisted of attendees (surgeons, non-surgical physicians, medical students) of the nine major annual conferences of the German Society of Surgery between 2008 and 2009. Participants filled in a single questionnaire including study-specific questions (demographic variables, professional position, and occupational situation) and a standardized quality of life instrument (Profiles of quality of life of the chronically ill, PLC). Surgeons' responses with regard to their professional situation and their quality of life were contrasted with those of the two controls (non-surgical physicians, medical students). Furthermore, PLC scores were compared with German population reference data and with reference data of several patient groups. Individuals (3,652) (2,991 surgeons, 561 non-surgical physicians, 100 medical students) participated in this study. The average age of surgeons and non-surgeons was in the low forties. In terms of professional qualifications, the majority of surgeons were residents (30%) and the majority of non-surgeons consultants in private practice (38%). Sixty-eight percent of the surgeons, only 39% of the non-surgeons worked more than 60 h per week on average (p family life due to work overload, more so than non-surgeons (74% vs. 59%, p quality of life as worse than that of the general public (non-surgeons, 22%; p quality of life even lower than that of their patients (non-surgeons, 17%; p quality of life questionnaire confirmed these results, showing score values lower than those of the German population reference data and of several patient

Becoming German: Integration, Citizenship and Territorialization of Germanness

DEFF Research Database (Denmark)

Fogelman, Tatiana

2017-01-01

understandings of integration and Germanness, this paper highlights the neglected aspect of the ascendance of Integrationspolitik since the turn of the century: namely how it superseded previous regime of completely bifurcated migration policy for "foreigners" on the one hand, and so-called "settlers" of German......, seen ever more as residing within its state territory rather than some diffuse cultural-linguistic space. Moving our understanding of Germanness beyond the "ethnic nationhood model" (Faist 2008), I argue thus that, in conjunction with the new citizenship law, the emergence of Integrationspolitik...

[Economic aspects of anesthesia. I. Health care reform in the German Republic].

Science.gov (United States)

Bach, A; Bauer, M

1998-03-01

Implications for Hospitals and Departments of Anaesthesiology. This article outlines the new German health care laws and their impact on the statutory health care system, hospitals and anaesthesia departments. The German health care system provides coverage for all citizens, although financial support from the public sector is on the downgrade. Hence, pressure to reduce public sector health care spending is likely to continue in the near future. Hospital costs account for one-third of total health care spending in Germany, and hospitals are facing increasing economic constraints: the volume and the charges for specific medical treatments are negotiated between the hospitals and the insurance agencies (or sickness funds) in advance. Only part of hospital care is still reimbursed on the basis of a per diem rate, and an increasing number of services are based on fixed payments per case or treatment. Reducing the costs for this treatment is therefore of utmost importance for hospitals and hospital departments. The prospective payment system and the pressure to contain costs demand a controlling system that allows for cost accounting per case. However, an economic evaluation must include comparative analysis of alternative therapeutic options in terms of both costs and outcome. Economic aspects challenge the traditional relationship between physicians and patients: doctors are still the advocates of their patients, but also act as agents for their institutions. Nevertheless, not only economic issues, but also ethical priorities and the value of an anaesthetic practice must be considered in the era of cost containment. Anaesthetists must be actively involved in providing high-quality care with its obvious benefits for the patient and be able to resist efforts to cut out expensive treatment modalities regardless of their benefits.

Psychometric properties of the Hospital Survey on Patient Safety Culture for hospital management (HSOPS_M

Directory of Open Access Journals (Sweden)

Pfeiffer Yvonne

2011-07-01

Full Text Available Abstract Background From a management perspective, it is necessary to examine how a hospital's top management assess the patient safety culture in their organisation. This study examines whether the Hospital Survey on Patient Safety Culture for hospital management (HSOPS_M has the same psychometric properties as the HSOPS for hospital employees does. Methods In 2008, a questionnaire survey including the HSOPS_M was conducted with 1,224 medical directors from German hospitals. When assessing the psychometric properties, we performed a confirmatory factor analysis (CFA. Additionally, we proved construct validity and internal consistency. Results A total of 551 medical directors returned the questionnaire. The results of the CFA suggested a satisfactory global data fit. The indices of local fit indicated a good, but not satisfactory convergent validity. Analyses of construct validity indicated that not all safety culture dimensions were readily distinguishable. However, Cronbach's alpha indicated that the dimensions had an acceptable level of reliability. Conclusion The analyses of the psychometric properties of the HSOPS_M resulted in reasonably good levels of property values. Although the set of dimensions within the HSOPS_M needs further scale refinement, the questionnaire covers a broad range of sub-dimensions and supplies important information on safety culture. The HSOPS_M, therefore, is eligible to measure safety culture from the hospital management's points of view and could be used in nationwide hospital surveys to make inter-organisational comparisons.

German Bowel Cancer Center: An Attempt to Improve Treatment Quality

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Olof Jannasch

2015-01-01

Full Text Available Background. Colorectal cancer remains the second most common cause of death from malignancies, but treatment results show high diversity. Certified bowel cancer centres (BCC are the basis of a German project for improvement of treatment. The aim of this study was to analyze if certification would enhance short-term outcome in rectal cancer surgery. Material and Methods. This quality assurance study included 8197 patients with rectal cancer treated between 1 January 2008 and 31 December 2010. We compared cohorts treated in certified and noncertified hospitals regarding preoperative variables and perioperative outcomes. Outcomes were verified by matched-pair analysis. Results. Patients of noncertified hospitals had higher ASA-scores, higher prevalence of risk factors, more distant metastases, lower tumour localization, lower frequency of pelvic MRI, and higher frequencies of missing values and undetermined TNM classifications (significant differences only. Outcome analysis revealed more general complications in certified hospitals (20.3% versus 17.4%, p=0.03. Both cohorts did not differ significantly in percentage of R0-resections, intraoperative complications, anastomotic leakage, in-hospital death, and abdominal wall dehiscence. Conclusions. The concept of BCC is a step towards improving the structural and procedural quality. This is a good basis for improving outcome quality but cannot replace it. For a primary surgical disease like rectal cancer a specific, surgery-targeted program is still needed.

[The role of patient flow and surge capacity for in-hospital response in mass casualty events].

Science.gov (United States)

Sefrin, Peter; Kuhnigk, Herbert

2008-03-01

Mass casualty events make demands on emergency services and disaster control. However, optimized in- hospital response defines the quality of definitive care. Therefore, German federal law governs the role of hospitals in mass casualty incidents. In hospital casualty surge is depending on resources that have to be expanded with a practicable alarm plan. Thus, in-hospital mass casualty management planning is recommended to be organized by specialized persons. To minimise inhospital patient overflow casualty surge principles have to be implemented in both, pre-hospital and in-hospital disaster planning. World soccer championship 2006 facilitated the initiation of surge and damage control principles in in-hospital disaster planning strategies for German hospitals. The presented concept of strict control of in-hospital patient flow using surge principles minimises the risk of in-hospital breakdown and increases definitive hospital treatment capacity in mass casualty incidents.

Redefining diagnosis-related groups (DRGs) for palliative care - a cross-sectional study in two German centres.

Science.gov (United States)

Vogl, Matthias; Schildmann, Eva; Leidl, Reiner; Hodiamont, Farina; Kalies, Helen; Maier, Bernd Oliver; Schlemmer, Marcus; Roller, Susanne; Bausewein, Claudia

2018-04-05

Hospital costs and cost drivers in palliative care are poorly analysed. It remains unknown whether current German Diagnosis-Related Groups, mainly relying on main diagnosis or procedure, reproduce costs adequately. The aim of this study was therefore to analyse costs and reimbursement for inpatient palliative care and to identify relevant cost drivers. Two-center, standardised micro-costing approach with patient-level cost calculations and analysis of the reimbursement situation for patients receiving palliative care at two German hospitals (7/2012-12/2013). Data were analysed for the total group receiving hospital care covering, but not exclusively, palliative care (group A) and the subgroup receiving palliative care only (group B). Patient and care characteristics predictive of inpatient costs of palliative care were derived by generalised linear models and investigated by classification and regression tree analysis. Between 7/2012 and 12/2013, 2151 patients received care in the two hospitals including, but not exclusively, on the PCUs (group A). In 2013, 784 patients received care on the two PCUs only (group B). Mean total costs per case were € 7392 (SD 7897) (group A) and € 5763 (SD 3664) (group B), mean total reimbursement per case € 5155 (SD 6347) (group A) and € 4278 (SD 2194) (group B). For group A/B on the ward, 58%/67% of the overall costs and 48%/53%, 65%/82% and 64%/72% of costs for nursing, physicians and infrastructure were reimbursed, respectively. Main diagnosis did not significantly influence costs. However, duration of palliative care and total length of stay were (related to the cost calculation method) identified as significant cost drivers. Related to the cost calculation method, total length of stay and duration of palliative care were identified as significant cost drivers. In contrast, main diagnosis did not reflect costs. In addition, results show that reimbursement within the German Diagnosis-Related Groups system does not

Tinnitus functional index: validation of the German version for Switzerland.

Science.gov (United States)

Peter, Nicole; Kleinjung, Tobias; Jeker, Raphael; Meyer, Martin; Klaghofer, Richard; Weidt, Steffi

2017-05-05

Different standardized questionnaires are used to assess tinnitus severity, making comparisons across studies difficult. These questionnaires are also used to measure treatment-related changes in tinnitus although they were not designed for this purpose. To solve these problems, a new questionnaire - the Tinnitus Functional Index (TFI) - has been established. The TFI is highly responsive to treatment-related change and promises to be the new gold standard in tinnitus evaluation. The aim of the current study was to validate a German version of the TFI for a German-speaking population in Switzerland. At the ENT department of the University Hospital Zurich, 264 subjects completed an online survey including the German version for Switzerland of TFI, Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and sociodemographic variables. Internal consistency of the TFI was calculated with Cronbach's alpha coefficient. Pearson correlation coefficients were used for the test-retest reliability of the TFI and to investigate convergent and discriminant validity between the THI and the BDI and BAI, respectively. Factor analysis was assessed using a principal component analysis with oblique rotation. The different factors extracted were then compared with the original questionnaire. The German version of the TFI for Switzerland showed an excellent internal consistency (Cronbach's alpha of 0.97) and an excellent test-retest reliability of 0.91. The convergent validity with THI was high (r = 0.86). The discriminant validity with BAI and BDI showed moderate results (BAI: r = 0.60 and BDI: r = 0.65). In the factor analysis only five factors with one main factor could be extracted instead of eight factors as described in the original version. Nevertheless, relations to the original eight subscales could be demonstrated. The German version of the TFI for Switzerland is a suitable instrument for measuring the impact of tinnitus

Results of a hospital waste survey in private hospitals in Fars province, Iran

International Nuclear Information System (INIS)

Askarian, Mehrdad; Vakili, Mahmood; Kabir, Gholamhosein

2004-01-01

Hospital waste is considered dangerous because it may possess pathogenic agents and can cause undesirable effects on human health and the environment. In Iran, neither rules have been compiled nor does exact information exist regarding hospital waste management. The survey presented in this article was carried out in all 15 private hospitals of Fars province (Iran) from the total numbers of 50 governmental and private hospitals located in this province, in order to determine the amount of different kinds of waste produced and the present situation of waste management. The results indicated that the waste generation rate is 4.45 kg/bed/day, which includes 1830 kg (71.44%) of domestic waste, 712 kg (27.8%) of infectious waste, and 19.6 kg (0.76%) of sharps. Segregation of the different types of waste is not carried out perfectly. Two (13.3%) of the hospitals use containers without lids for on-site transport of wastes. Nine (60%) of the hospitals are equipped with an incinerator and six of them (40%) have operational problems with the incinerators. In all hospitals municipal workers transport waste outside the hospital premises daily or at the most on alternative days. In the hospitals under study, there aren't any training courses about hospital waste management and the hazards associated with them. The training courses that are provided are either ineffective or unsuitable. Performing extensive studies all over the country, compiling and enacting rules, establishing standards and providing effective personnel training are the main challenges for the concerned authorities and specialists in this field

Can soda fountains be recommended in hospitals?

Science.gov (United States)

Chaberny, Iris F; Kaiser, Peter; Sonntag, Hans-Günther

2006-09-01

Mineral water (soda water) is very popular in Germany. Therefore, soda fountains were developed as alternatives to the traditional deposit bottle system. Nowadays, different systems of these devices are commercially available. For several years, soda fountains produced by different companies have been examined at the University Hospital of Heidelberg. In 1998, it was possible for the first time to observe and evaluate one of these systems over a period of 320 days in a series of microbiological examinations. The evaluation was implemented on the basis of the German drinking water regulation (Anonymous, 1990. Gesetz über Trinkwasser und Wasser für Lebensmittelbetriebe (Trinkwasserverordnung - TrinkwV) vom 12. Dezember 1990. Bundesgesetzblatt 66, 2613ff). Initially, the bacteria counts exceeded the reference values imposed by the German drinking water regulation in almost 50% of the analyses. Pseudomonas aeruginosa was also detected in almost 38% of the samples. After a re-arrangement of the disinfection procedure and the removal of the charcoal filter, Pseudomonas aeruginosa was not detectable any more. However, the bacteria counts still frequently exceeded the reference values of the German drinking water regulation. Following our long-term analysis, we would not recommend soda fountains in high-risk areas of hospitals. If these devices are to be used in hospitals, the disinfection procedures should be executed in weekly or fortnightly intervals and the water quality should be examined periodically.

Infection prevention during anaesthesia ventilation by the use of breathing system filters (BSF): Joint recommendation by German Society of Hospital Hygiene (DGKH) and German Society for Anaesthesiology and Intensive Care (DGAI).

Science.gov (United States)

Kramer, Axel; Kranabetter, Rainer; Rathgeber, Jörg; Züchner, Klaus; Assadian, Ojan; Daeschlein, Georg; Hübner, Nils-Olaf; Dietlein, Edeltrut; Exner, Martin; Gründling, Matthias; Lehmann, Christian; Wendt, Michael; Graf, Bernhard Martin; Holst, Dietmar; Jatzwauk, Lutz; Puhlmann, Birgit; Welte, Thomas; Wilkes, Antony R

2010-09-21

An interdisciplinary working group from the German Society of Hospital Hygiene (DGKH) and the German Society for Anaesthesiology and Intensive Care (DGAI) worked out the following recommendations for infection prevention during anaesthesia by using breathing system filters (BSF). The BSF shall be changed after each patient. The filter retention efficiency for airborne particles is recommended to be >99% (II). The retention performance of BSF for liquids is recommended to be at pressures of at least 60 hPa (=60 mbar) or 20 hPa above the selected maximum ventilation pressure in the anaesthetic system. The anaesthesia breathing system may be used for a period of up to 7 days provided that the functional requirements of the system remain unchanged and the manufacturer states this in the instructions for use.THE BREATHING SYSTEM AND THE MANUAL VENTILATION BAG ARE CHANGED IMMEDIATELY AFTER THE RESPECTIVE ANAESTHESIA IF THE FOLLOWING SITUATION HAS OCCURRED OR IT IS SUSPECTED TO HAVE OCCURRED: Notifiable infectious disease involving the risk of transmission via the breathing system and the manual bag, e.g. tuberculosis, acute viral hepatitis, measles, influenza virus, infection and/or colonisation with a multi-resistant pathogen or upper or lower respiratory tract infections. In case of visible contamination e.g. by blood or in case of defect, it is required that the BSF and also the anaesthesia breathing system is changed and the breathing gas conducting parts of the anaesthesia ventilator are hygienically reprocessed.Observing of the appropriate hand disinfection is very important. All surfaces of the anaesthesia equipment exposed to hand contact must be disinfected after each case.

Does the 'Teddy Bear Hospital' enhance preschool children's knowledge? A pilot study with a pre/post-case control design in Germany.

Science.gov (United States)

Leonhardt, Corinna; Margraf-Stiksrud, Jutta; Badners, Larissa; Szerencsi, Andrea; Maier, Rolf F

2014-10-01

The 'Teddy Bear Hospital' is a medical students' project, which has been increasingly established in many countries. To evaluate this concept, we examined the effects of a German Teddy Bear Hospital on children's knowledge relating to their body, health and disease. Using a quasi-experimental pre/post design, we examined 131 preschool children from 14 German kindergartens with pictorial interview-based scales. The analysis of covariance revealed that the children who visited the Teddy Bear Hospital had a significantly better knowledge concerning their body, health and disease than the children from the control group. This German Teddy Bear Hospital is a good health education vehicle for preschool children. © The Author(s) 2013.

Human resource crises in German hospitals?an explorative study

OpenAIRE

Schermuly, Carsten C; Draheim, Michael; Glasberg, Ronald; Stantchev, Vladimir; Tamm, Gerrit; Hartmann, Michael; Hessel, Franz

2015-01-01

Background The complexity of providing medical care in a high-tech environment with a highly specialized, limited labour force makes hospitals more crisis-prone than other industries. An effective defence against crises is only possible if the organizational resilience and the capacity to handle crises become part of the hospitals? organizational culture. To become more resilient to crises, a raised awareness?especially in the area of human resource (HR)?is necessary. The aim of this paper is...

Genome-based analysis of Carbapenemase-producing Klebsiella pneumoniae isolates from German hospital patients, 2008-2014.

Science.gov (United States)

Becker, Laura; Kaase, Martin; Pfeifer, Yvonne; Fuchs, Stephan; Reuss, Annicka; von Laer, Anja; Sin, Muna Abu; Korte-Berwanger, Miriam; Gatermann, Sören; Werner, Guido

2018-01-01

By using whole genome sequence data we aimed at describing a population snapshot of carbapenemase-producing K. pneumoniae isolated from hospitalized patients in Germany between 2008 and 2014. We selected a representative subset of 107 carbapenemase-producing K. pneumoniae clinical isolates possessing the four most prevalent carbapenemase types in Germany (KPC-2, KPC-3, OXA-48, NDM-1). Isolates were processed via illumina NGS. Data were analysed using different SNP-based mapping and de-novo assembly approaches. Relevant information was extracted from NGS data (antibiotic resistance determinants, wzi gene/ cps type, virulence genes). NGS data from the present study were also compared with 238 genome data from two previous international studies on K. pneumoniae. NGS-based analyses revealed a preferred prevalence of KPC-2-producing ST258 and KPC-3-producing ST512 isolates. OXA-48, being the most prevalent carbapenemase type in Germany, was associated with various K. pneumoniae strain types; most of them possessing IncL/M plasmid replicons suggesting a preferred dissemination of bla OXA-48 via this well-known plasmid type. Clusters ST15, ST147, ST258, and ST512 demonstrated an intermingled subset structure consisting of German and other European K. pneumoniae isolates. ST23 being the most frequent MLST type in Asia was found only once in Germany. This latter isolate contained an almost complete set of virulence genes and a K1 capsule suggesting occurrence of a hypervirulent ST23 strain producing OXA-48 in Germany. Our study results suggest prevalence of "classical" K. pneumonaie strain types associated with widely distributed carbapenemase genes such as ST258/KPC-2 or ST512/KPC-3 also in Germany. The finding of a supposed hypervirulent and OXA-48-producing ST23 K. pneumoniae isolates outside Asia is highly worrisome and requires intense molecular surveillance.

Dictionary for veterinary science and biosciences. German-English/English-German. With trilingual appendix: Latin terms

International Nuclear Information System (INIS)

Mack, R.

1988-01-01

This dictionary has been compiled as a result of many years experience of translating German texts in the biological sciences, particularly veterinary medicine. The author's aim is to supplement the standard German-English general dictionaries with technical terms to in the fields of anatomy, microbiology, physiology, parasitology, pathology, pharmacology, toxicology and zootechny, with special reference to domestic animals and their diseases. (orig.) [de

[Caesarean section in german hospitals: validity of hospital quality report data for monitoring C-section rates].

Science.gov (United States)

Junghänel, K; Renz-Polster, H; Jarczok, M N; Hornemann, A; Böhler, T; De Bock, F

2015-04-01

It is not known if "hospital quality reports" (HQR) document Caesarean (C-) section rates at the hospital level accurately enough for use as a reliable data source when it comes to explaining regional variations of C-sections in Germany by factors at the hospital level. We aimed to answer this question using HQR from hospitals in Baden-Württemberg as data source. Diagnostic and procedure codes from HQR for the year 2008 (HQRdata), were used to calculate numbers of births, numbers of C-sections, and rates of births by C-section (CSR) for 94 of 97 hospitals in Baden-Württemberg. These numbers were compared to internal hospital (IH) data delivered upon request by 80 of 97 hospitals and stemming from vital statistics, birth registry forms, or external quality assurance datasets. There was no difference in the number of births between HQR data and IH data, but the number of C-sections and the CSR differed significantly (pCSR calculated using HQR data was 4.9 ± 17.9% higher than CSR from IH data (absolute difference 1.5 ± 5.8%). The correlation between the 2 data sources was moderate (r=0.73). Only 55% of the variance in IH data-based CSR was explained by HQR data. The proportion between highest and lowest CSR in hospitals in Baden-Württemberg was 4.9 for HQR data and 3.6 for IH data. There are significant and relevant differences between C-section rates based on ei-ther HQR or IH data. This questions routine data from HQR for 2008 as a reliable data source for research work. © Georg Thieme Verlag KG Stuttgart · New York.

Agora Energiewende (2017). Future cost of onshore wind. Recent auction results, long-term outlook and implications for upcoming German auctions

Energy Technology Data Exchange (ETDEWEB)

Thomassen, Georg; Deutsch, Matthias

2017-04-15

The costs for electricity from renewable generation have been falling significantly in recent years, and record low bids at auctions around the world have grasped the attention of the public. Solar photovoltaics and offshore wind auctions, in particular, have attracted a lot of interest. The results for onshore wind, however, are just as impressive. The future cost development of onshore wind is of great relevance, since it is a key pillar of the energy system transformation in many parts of the world. However, the estimated long-term cost reductions vary significantly, as different studies value the cost drivers of wind differently. In Germany, the opaque and complex cost structure of onshore wind is the root of much controversy. International auction results with winning bids of less than half of the typical German pay rate left people questioning the costs of domestic wind power. However this discussion often fails to account adequately for differences in the quality of wind resources. In light of the upcoming, and first, German onshore wind auctions, we aim to contribute to the ongoing discussion by providing the necessary context for international auction results, a general outlook on the future cost of onshore wind, and by illustrating the existing potential and hindrances for cost reductions in the German market.

Agora Energiewende (2017). Future cost of onshore wind. Recent auction results, long-term outlook and implications for upcoming German auctions

International Nuclear Information System (INIS)

Thomassen, Georg; Deutsch, Matthias

2017-01-01

The costs for electricity from renewable generation have been falling significantly in recent years, and record low bids at auctions around the world have grasped the attention of the public. Solar photovoltaics and offshore wind auctions, in particular, have attracted a lot of interest. The results for onshore wind, however, are just as impressive. The future cost development of onshore wind is of great relevance, since it is a key pillar of the energy system transformation in many parts of the world. However, the estimated long-term cost reductions vary significantly, as different studies value the cost drivers of wind differently. In Germany, the opaque and complex cost structure of onshore wind is the root of much controversy. International auction results with winning bids of less than half of the typical German pay rate left people questioning the costs of domestic wind power. However this discussion often fails to account adequately for differences in the quality of wind resources. In light of the upcoming, and first, German onshore wind auctions, we aim to contribute to the ongoing discussion by providing the necessary context for international auction results, a general outlook on the future cost of onshore wind, and by illustrating the existing potential and hindrances for cost reductions in the German market.

A German catastrophe? German historians and the Allied bombings, 1945-2010

NARCIS (Netherlands)

von Benda-Beckmann, B.R.

2010-01-01

As one of the major symbols of German suffering, the Allied bombing war left a strong imprint on German society. To a much wider extent than is often claimed, the Allied bombings became part of German debates on the Second World War. In both the GDR as well as the Federal Republic before and after

[The boycott against German scientists and the German language after World War I].

Science.gov (United States)

Reinbothe, R

2013-12-01

After the First World War, the Allied academies of sciences staged a boycott against German scientists and the German language. The objective of the boycott was to prevent the re-establishment of the prewar dominance of German scientists, the German language and German publications in the area of international scientific cooperation. Therefore the Allies excluded German scientists and the German language from international associations, congresses and publications, while they created new international scientific organizations under their leadership. Medical associations and congresses were also affected, e. g. congresses on surgery, ophthalmology and tuberculosis. Allied physicians replaced the "International Anti-Tuberculosis Association" founded in Berlin in 1902 with the "Union Internationale contre la Tuberculose"/"International Union against Tuberculosis", founded in Paris in 1920. Only French and English were used as the official languages of the new scientific organizations, just as in the League of Nations. The boycott was based on the fact that the German scientists had denied German war guilt and war crimes and glorified German militarism in a manifesto "To The Civilized World!" in 1914. The boycott first started in 1919 and had to be abolished in 1926, when Germany became a member of the League of Nations. Many German and foreign physicians as well as other scientists protested against the boycott. Some German scientists and institutions even staged a counter-boycott impeding the resumption of international collaboration. The boycott entailed an enduring decline of German as an international scientific language. After the Second World War scientists of the victorious Western Powers implemented a complete reorganization of the international scientific arena, based on the same organizational structures and language restrictions they had built up in 1919/1920. At the same time scientists from the U.S.A. staged an active language and publication policy, in

[Cardiovascular medicine in the German diagnosis-related group--(G-DRG) system 2005].

Science.gov (United States)

Fürstenberg, T; Bunzemeier, H; Roeder, N; Reinecke, H

2005-05-01

The German diagnosis-related Group (G-DRG) System has recently been published in its third version. From 2005 on, this system will be the definite measure for the budgets of nearly all german hospitals. The preliminary phase with no budget reduction or redistribution being made and in which an inappropriate classification system had no negative impact on reimbursement has, thus, come to an end. At present, many hospitals are struggling in an economic competition about the independence or maintenance of the hospital or several sub-departments. The changes in the classification system with regard to a marked increase in the number of G DRGs, a modified grouping-logic, more properly determined reductions and extra charges for low and high outlier as well as the introduction of further additional charges contribute thereby to a better covering of services and treatments of cardiovascular patients. However, while many of the known problems have been eliminated, there are still weaknesses in the G-DRG System even concerning cardiovascular medicine. The G-DRG System has to be adapted continuously with consultation of the clinical expertise of the respective medical societies. The most important new aspects and changes in the G-DRG System 2005 and the accompanied execution regulations are explained with special view on cardiology.

Meeting the nutritional requirements of hospitalized patients: an interdisciplinary approach to hospital catering.

Science.gov (United States)

Iff, S; Leuenberger, M; Rösch, S; Knecht, G; Tanner, B; Stanga, Z

2008-12-01

The study served to assure the quality of our catering, to locate problems, and to define further optimization measures at the Bern University Hospital. The main objective was to investigate whether the macronutrient and energy content of the hospital food complies with the nutritional value calculated from recipes as well as with the recommendations issued by the German Nutrition Society (DGE). Prospective, randomized, single-center quality study. Complete standard meals were analyzed over seven consecutive days for each seasonal menu plan in one year. The quantitative and qualitative chemical content of a randomly chosen menu was determined by an external laboratory. Sixty meals were analyzed. The amount of food served and the ratio of macronutrients contained in the food satisfactorily reflected all recipes. Not surprisingly, the energy and carbohydrate content of our meals was lower than in the German recommendations, because the report of the DGE is based on the sum of meals, snacks and beverages consumed over the whole day and not only on the main meals, as we analyzed. Periodic quality control is essential in order to meet recommendations and patients' expectations in hospital catering. Members of the catering service should undergo regularly repeated skills training, and continuous efforts should be made to ensure portion size for all delivered meals. Food provision in the hospital setting needs to be tailored to meet the demands of the different patient groups, to optimize nutritional support, and to minimize food waste.

[A paradigm change in German academic medicine. Merger and privatization as exemplified with the university hospitals in Marburg and Giessen].

Science.gov (United States)

Maisch, Bernhard

2005-03-01

1. The intended fusion of the university hospitals Marburg and Giessen in the state of Hessia is "a marriage under pressure with uncalculated risk" (Spiegel 2005). In the present political and financial situation it hardly appears to be avoidable. From the point of the view of the faculty of medicine in Marburg it is difficult to understand, that the profits of this well guided university hospital with a positive yearly budget should go to the neighboring university hospital which still had a fair amount of deficit spending in the last years.2. Both medical faculties suffer from a very low budget from the state of Hessia for research and teaching. Giessen much more than Marburg, have a substantial need for investments in buildings and infrastructure. Both institutions have a similar need for investments in costly medical apparatuses. This is a problem, which many university hospitals face nowadays.3. The intended privatisation of one or both university hospitals will need sound answers to several fundamental questions and problems:a) A privatisation potentially endangers the freedom of research and teaching garanteed by the German constitution. A private company will undoubtedly influence by active or missing additional support the direction of research in the respective academic institution. An example is the priorisation of clinical in contrast to basic research.b) With the privatisation practical absurdities in the separation of research and teaching on one side and hospital care on the other will become obvious with respect to the status of the academic employees, the obligatory taxation (16%) when a transfer of labor from one institution to the other is taken into account. The use of rooms for seminars, lectures and bedside with a double function for both teaching, research and hospital care has to be clarified with a convincing solution in everyday practice.c) The potential additional acquisition of patients, which has been advocated by the Hessian state

[Hospitals failing minimum volumes in 2004: reasons and consequences].

Science.gov (United States)

Geraedts, M; Kühnen, C; Cruppé, W de; Blum, K; Ohmann, C

2008-02-01

In 2004 Germany introduced annual minimum volumes nationwide on five surgical procedures: kidney, liver, stem cell transplantation, complex oesophageal, and pancreatic interventions. Hospitals that fail to reach the minimum volumes are no longer allowed to perform the respective procedures unless they raise one of eight legally accepted exceptions. The goal of our study was to investigate how many hospitals fell short of the minimum volumes in 2004, whether and how this was justified, and whether hospitals that failed the requirements experienced any consequences. We analysed data on meeting the minimum volume requirements in 2004 that all German hospitals were obliged to publish as part of their biannual structured quality reports. We performed telephone interviews: a) with all hospitals not achieving the minimum volumes for complex oesophageal, and pancreatic interventions, and b) with the national umbrella organisations of all German sickness funds. In 2004, one quarter of all German acute care hospitals (N=485) performed 23,128 procedures where minimum volumes applied. 197 hospitals (41%) did not meet at least one of the minimum volumes. These hospitals performed N=715 procedures (3.1%) where the minimum volumes were not met. In 43% of these cases the hospitals raised legally accepted exceptions. In 33% of the cases the hospitals argued using reasons that were not legally acknowledged. 69% of those hospitals that failed to achieve the minimum volumes for complex oesophageal and pancreatic interventions did not experience any consequences from the sickness funds. However, one third of those hospitals reported that the sickness funds addressed the issue and partially announced consequences for the future. The sickness funds' umbrella organisations stated that there were only sparse activities related to the minimum volumes and that neither uniform registrations nor uniform proceedings in case of infringements of the standards had been agreed upon. In spite of the

Validation and reliability of the VF-14 questionnaire in a German population.

Science.gov (United States)

Chiang, Peggy Pei-Chia; Fenwick, Eva; Marella, Manjula; Finger, Robert; Lamoureux, Ecosse

2011-11-21

To evaluate the validity, reliability, and measurement characteristics of the Visual Function 14 (VF-14) in a German sample using Rasch analysis. This was a clinic-based, cross-sectional study with 184 patients with low vision recruited from an outpatient clinic at a German eye hospital. Participants underwent a clinical examination and completed the German VF-14 scale. The validity of the VF-14 scale was assessed using Rasch analysis. The main outcome measure was the overall functional score provided by the VF-14. After collapsing two response categories for items 13 and 14, the VF-14 scale satisfied fundamental criteria to achieve fit to the Rasch model, namely, ordered thresholds, the ability to distinguish between different strata of participant ability, absence of misfitting items, no evidence of unidimensionality, and no significant differential item functioning for key sociodemographic covariates. The VF-14 is able to discriminate between participants with different levels of vision impairment and across different cultural groups. The VF-14 is a valid, reliable, and unidimensional questionnaire for use in a German population. These findings contribute to the growing evidence base for second generation patient reported outcome measures in ophthalmology, and support the use of the German VF-14 in tertiary eye clinics in Germany to capture the impact of visual impairment on visual function from the patient's perspective and to inform low vision rehabilitation and interventions.

Interviewing German scientists on climate change. A preliminary study

Energy Technology Data Exchange (ETDEWEB)

Ungar, S. [GKSS-Forschungszentrum Geesthacht GmbH (Germany). Inst. fuer Kuestenforschung; Toronto Univ., Scarborough (Canada)

2004-07-01

This study is based on in-depth interviews with 25 German scientists at the Coastal Research Institute of the GKSS-Forschungszentrum. It takes as its context the differential rhetoric and planning on climate change found in Germany and North America. The interviews try to throw light on the early German decision to address climate change, and to assess the current attitudes, beliefs and experiences of these German scientists. The results reveal a degree of complacency among these scientists, including a sense that Germany is not particularly threatened by climate change and has the capacity to adapt to it. The scientists are critical of inaction among the German population, but themselves uphold a ''light version'' of the precautionary principle. They have great difficulty translating the idea of climate change into popular metaphors that can be grasped by children. They strongly reject any link between German leadership on the issue as a result of a sense of guilt about the German past. (orig.)

Care of cancer patients at the end of life in a German university hospital: A retrospective observational study from 2014.

Directory of Open Access Journals (Sweden)

Burkhard Dasch

Full Text Available Cancer care including aggressive treatment procedures during the last phase of life in patients with incurable cancer has increasingly come under scrutiny, while integrating specialist palliative care at an early stage is regarded as indication for high quality end-of-life patient care.To describe the demographic and clinical characteristics and the medical care provided at the end of life of cancer patients who died in a German university hospital.Retrospective cross-sectional study on the basis of anonymized hospital data for cancer patients who died in the Munich University Hospital in 2014. Descriptive analysis and multivariate logistic regression analyses for factors influencing the administration of aggressive treatment procedures at the end of life.Overall, 532 cancer patients died. Mean age was 66.8 years, 58.5% were men. 110/532 (20.7% decedents had hematologic malignancies and 422/532 (79.3% a solid tumor. Patients underwent the following medical interventions in the last 7/30 days: chemotherapy (7.7%/38.3%, radiotherapy (2.6%/6.4%, resuscitation (8.5%/10.5%, surgery (15.2%/31.0%, renal replacement therapy (12.0%/16.9%, blood transfusions (21.2%/39.5%, CT scan (33.8%/60.9%. In comparison to patients with solid tumors, patients with hematologic malignancies were more likely to die in intensive care (25.4% vs. 49.1%; p = 0.001, and were also more likely to receive blood transfusions (OR 2.21; 95% CI, 1.36 to 3.58; p = 0.001 and renal replacement therapy (OR 2.65; 95% CI, 1.49 to 4.70; p = 0.001 in the last 7 days of life. Contact with the hospital palliative care team had been initiated in 161/532 patients (30.3%. In 87/161 cases (54.0%, the contact was initiated within the last week of the patient's life.Overambitious treatments are still reality at the end of life in cancer patients in hospital but patients with solid tumors and hematologic malignancies have to be differentiated. More efforts are necessary for the timely inclusion of

Massive job cuts threaten East German science

CERN Multimedia

Hamer, M

1990-01-01

German reunification could result in thousands of scientists losing their jobs. At the end of this year the East German state budget for science will run out. Scientists in the East are keen to find Western support to protect their research (1 page).

Results of the German alternative fuel cycle evaluation and further efforts geared toward demonstration of direct disposal

International Nuclear Information System (INIS)

Papp, R.; Closs, K.D.

1986-01-01

In a comparative study initiated by the German Federal Ministry for Research and Technology which was carried out by Karlsruhe Nuclear Research Center in the period from 1981 to 1985, direct disposal of spent fuel was contrasted to the traditional fuel cycle with reprocessing and recycle. The results of the study did not exhibit decisive advantages of direct disposal over fuel reprocessing. Due to this face and legal requirements of the German Atomic Energy Act, the cabinet concluded to continue to adhere to fuel reprocessing as the preferred version of ''Entsorgung''. But the door was left ajar for the direct disposal alternative that, under present atomic law, is permissible for fuel for which reprocessing is neither technically feasible nor economically justified. An ambitious program has been launched in the Federal Republic of Germany (FRG), geared to bring direct disposal to a point of technical maturity

Robots drive the German radical prostatectomy market: a total population analysis from 2006 to 2013.

Science.gov (United States)

Groeben, C; Koch, R; Baunacke, M; Wirth, M P; Huber, J

2016-12-01

To assess trends in the distribution of patients for radical prostatectomy in Germany from 2006 to 2013 and the impact of robotic surgery on annual caseloads. We hypothesized that the advent of robotics and the establishment of certified prostate cancer centers caused centralization in the German radical prostatectomy market. Using remote data processing we analyzed the nationwide German billing data from 2006 to 2013. We supplemented this database with additional hospital characteristics like the prostate cancer center certification status. Inclusion criteria were a prostate cancer diagnosis combined with radical prostatectomy. Hospitals with certification or a surgical robot in 2009 were defined as 'early' group. Linear covariant-analytic models were applied to describe trends over time. Annual radical prostatectomy numbers declined from 28 374 (2006) to 21 850 (2013). High-volume hospitals (⩾100 cases) decreased from 87 (22.0%) in 2006 to 43 (10.4%) in 2013. Low-volume hospitals (200 cases per year contrary to the overall trend (Pdecentralization of radical prostatectomy in Germany. The driving force for this development might consist in the overall decline of radical prostatectomy numbers. The most important factor for achieving higher caseloads was the presence of a robotic system. In order to optimize outcomes of radical prostatectomy additional health policy measures might be necessary.

Word order in the Germanic languages

DEFF Research Database (Denmark)

Holmberg, Anders; Rijkhoff, Jan

1998-01-01

The Germanic branch of Indo-European consists of three main groups (Ruhlen 1987: 327):- East Germanic: Gothic, Vandalic, Burgundian (all extinct);- North Germanic (or: Scandinavian): Runic (extinct), Danish, Swedish, Norwegian, Icelandic, Faroese;- West Germanic: German, Yiddish, Luxembourgeois, ...

[Reading behavior and preferences regarding subscriptions to scientific journals : Results of a survey of members of the German Society for General and Visceral Surgery].

Science.gov (United States)

Ronellenfitsch, U; Klinger, C; Buhr, H J; Post, S

2015-11-01

The purpose of surgical literature is to publish the latest study results and to provide continuing medical education to readers. For optimal allocation of resources, institutional subscribers, professional societies and scientific publishers require structured data on reading and subscription preferences of potential readers of surgical literature. To obtain representative data on the preferences of German general and visceral surgeons regarding reading of and subscription to scientific journals. All members of the German Society for General and Visceral Surgery (DGAV) were invited to participate in a web-based survey. Questions were asked on the affiliation and position of the member, individual journal subscriptions, institutional access to scientific journals, preferences regarding electronic or print articles and special subscriptions for society members. Answers were descriptively analyzed. A total of 630 out of 4091 (15 %) members participated in the survey and 73 % of the respondents had at least 1 individual subscription to a scientific journal. The most frequently subscribed journal was Der Chirurg (47 % of respondents). The institutional access to journals was deemed insufficient by 48 % of respondents, predominantly in primary care hospitals and outpatient clinics. Almost half of the respondents gave sufficient importance to reading printed versions of articles for which they would pay extra fees. A group subscription for society members was perceived as advantageous as long as no relevant extra costs were incurred. This structured survey among members of the DGAV provides data on preferences regarding reading of and subscription to scientific journals. Individual subscriptions to journals are still common, possibly due to suboptimal institutional access particularly at smaller non-academic institutions. In an age of online publications it seems surprising that many respondents place a high value on printed versions. The results are relevant for

German energy policy in deregulated Europe

International Nuclear Information System (INIS)

Kuhnt, D.

2000-01-01

The author argues in favor of a more fact-oriented German energy policy: Firstly, German energy policy must accept the new European framework of a market economy. This means that German utilities must no longer be burdened with the implementation of political objectives. The German power industry needs a level playing field for competition on a European scale. Consequently, also the European partner countries should not limit themselves to the minimum conditions of the Single Market Directive in opening their markets. Secondly, German energy policy must develop new forms of cooperation with the power industry so as to maintain domestic employment and the addition of value despite considerably stronger competitive pressure. Also the conflicting targets of sustainability, continuity of supply, and economic viability must not only be discussed, but must be turned into productive approaches. Thirdly, this means that there must be no inadmissible solution in matters nuclear. If the German power industry is to remain strong, in the interest of domestic jobs and opportunities for the future, it must not lose any more domestic market share to other European companies. Fourthly, we need a new energy policy which takes cognizance of the results of market development in a more rational, less emotional way. In this respect, it should be limited henceforth to supporting renewable energies and technologies so as to enhance energy efficiency in line with market requirements. Fifthly, German energy policy must not commit the mistake of enforcing deregulation and, at the same time, exempting large segments of the market from competition. Thus, the planned expansion of renewable energies, and the increase in cogeneration to more than thirty percent of the German electricty generation, by way of quotas and revenues for electricity from these sources fed into the public grid, are incompatible with competition in Europe. The electricity tax within the framework of the eco tax, the

Problems raised by the results of the German reactor risk study

International Nuclear Information System (INIS)

Huebschmann, W.G.; Vogt, S.

1982-01-01

The main subject of the German Reactor Risk Study is the assessment of the collective risk to the public due to the nuclear power plant operation - particularly due to uncontrolled accidents - in the Federal Republic of Germany. Whereas the collective risk is reasonably small as compared to other risks, the study also revealed the low probability end of maximum consequences, which are large enough - although extremely improbable - as to be termed catastrophic. It is shown, however, that the maximum number of early fatalities is strongly dependent on some conservative assumptions and on roughly averaged parameters. The results of recent research work suggest for example that the steam explosion can be neglected and the chemical reaction of radioiodine in the containment should be taken into account. The activity deposition on the ground should be simulated more realistically if single cases such as the maximum are to be evaluated. The possible margin of conservatism of the maximum consequences is shown to be more than one order of magnitude. (author)

Lexical Reading in Dysfluent Readers of German

Science.gov (United States)

Gangl, Melanie; Moll, Kristina; Jones, Manon W.; Banfi, Chiara; Schulte-Körne, Gerd; Landerl, Karin

2018-01-01

Dyslexia in consistent orthographies like German is characterized by dysfluent reading, which is often assumed to result from failure to build up an orthographic lexicon and overreliance on decoding. However, earlier evidence indicates effects of lexical processing at least in some German dyslexic readers. We investigated variations in reading…

[MusiQol: international questionnaire investigating quality of life in multiple sclerosis: validation results for the German subpopulation in an international comparison].

Science.gov (United States)

Flachenecker, P; Vogel, U; Simeoni, M C; Auquier, P; Rieckmann, P

2011-10-01

The existing health-related quality of life questionnaires on multiple sclerosis (MS) only partially reflect the patient's point of view on the reduction of activities of daily living. Their development and validation was not performed in different languages. That is what prompted the development of the Multiple Sclerosis International Quality of Life (MusiQoL) Questionnaire as an international multidimensional measurement instrument. This paper presents this new development and the results of the German subgroup versus the total international sample. A total of 1,992 MS patients from 15 countries, including 209 German patients, took part in the study between January 2004 and February 2005. The patients took the MusiQoL survey at baseline and at 21±7 days as well as completing a symptom-related checklist and the SF-36 short form survey. Demographics, history and MS classification data were also generated. Reproducibility, sensitivity, convergent and discriminant validity were analysed. Convergent and discriminant validity and reproducibility were satisfactory for all dimensions of the MusiQoL. The dimensional scores correlated moderately but significantly with the SF-36 scores, but showed a discriminant validity in terms of gender, socioeconomic status and health status that was more pronounced in the overall population than in the German subpopulation. The highest correlations were observed between the MusiQoL dimension of activities of daily living and the Expanded Disability Status Scale (EDSS). The results of this study confirm the validity and reliability of MusiQoL as an instrument for measuring the quality of life of German and international MS patients.

Safety climate in Swiss hospital units: Swiss version of the Safety Climate Survey

Science.gov (United States)

Gehring, Katrin; Mascherek, Anna C.; Bezzola, Paula

2015-01-01

Abstract Rationale, aims and objectives Safety climate measurements are a broadly used element of improvement initiatives. In order to provide a sound and easy‐to‐administer instrument for the use in Swiss hospitals, we translated the Safety Climate Survey into German and French. Methods After translating the Safety Climate Survey into French and German, a cross‐sectional survey study was conducted with health care professionals (HCPs) in operating room (OR) teams and on OR‐related wards in 10 Swiss hospitals. Validity of the instrument was examined by means of Cronbach's alpha and missing rates of the single items. Item‐descriptive statistics group differences and percentage of ‘problematic responses’ (PPR) were calculated. Results 3153 HCPs completed the survey (response rate: 63.4%). 1308 individuals were excluded from the analyses because of a profession other than doctor or nurse or invalid answers (n = 1845; nurses = 1321, doctors = 523). Internal consistency of the translated Safety Climate Survey was good (Cronbach's alpha G erman = 0.86; Cronbach's alpha F rench = 0.84). Missing rates at item level were rather low (0.23–4.3%). We found significant group differences in safety climate values regarding profession, managerial function, work area and time spent in direct patient care. At item level, 14 out of 21 items showed a PPR higher than 10%. Conclusions Results indicate that the French and German translations of the Safety Climate Survey might be a useful measurement instrument for safety climate in Swiss hospital units. Analyses at item level allow for differentiating facets of safety climate into more positive and critical safety climate aspects. PMID:25656302

Evaluation of Five Local Formulated Insecticides against German Cockroach (Blattella germanica L. in Southern Iran

Directory of Open Access Journals (Sweden)

M Shahi

2008-06-01

Full Text Available Background: The German cockroach, Blattella germanica L., is a serious household and public health pest worldwide. Con­trol of this species has been very difficult to achieve. Toxicity of cypermethrin EC10%, deltamethrin EC5%, diazi­non EC0.5%, lambda-cyhalothrin EC5% and Negon® (permethrin+propoxur oil liquid1% commercial for­mula­tions were investigated against adult males of German cockroaches collected from four hospitals of Bandar Abbas City, southern Iran, during 2006. These insecticides have been used for cockroach con­trol in this city.Methods: The tests were carried out only on males by the glass jar contact method recommended by the WHO.Results: Maximum mortality rates of 20, 35, 90, and 100% were obtained after one hour contact to label-recom­mended doses of cypermethrin, deltamethrin, lambad-cyhalothrin, diazinon and permethrin+propoxur insecti­cides, respectively. KT50 results were different from 5.68 min for permethrin+propoxur mixture to 240.37 min for cyper­methrin. German cockroach showed < 80 per cent mortality using three pyrethroid insecticides.Conclusion: It seems that the label-recommended concentrations of these insecticides were wrong and lower than WHO advised for cockroach control. For monitoring of resistance it is recommended to do more tests using the pure ac­tive ingredient of these insecticides.

TANDEM - French-German cooperation for local energy transition. 2014-2017 results, 2017-2019 prospects

International Nuclear Information System (INIS)

Turfin, Anne; Maurer, Christiane; Schilken, Peter; Mouchard, Claire; Coquio, Rozenn; Kynast, Helmi

2016-11-01

The simultaneous implementation of the 'Transition energetique' process in France and of the 'Energiewende' process in Germany has resulted in the signature of a number of cooperation agreements between the two States. Since both these energy transition processes are largely based on decentralising energy supplies, close local authority cooperation looks promising. The TANDEM project is jointly led by two local authority networks, Energy Cities and Klima-Buendnis, with co-funding from ADEME (French Environment and Energy Management Agency) and UBA (German Federal Environment Agency). The TANDEM project provides French and German local authorities with a unique opportunity to share information and cooperate on climate protection issues in order to: provide improved mutual understanding of the situation, challenges and framework of climate and energy policies; encourage exchanges on the obstacles and leverages impeding or fostering the attainment of ambitious energy and climate objectives and encourage knowledge transfer; boost close cooperation between local authorities from both countries, involving local stakeholders and citizens; implement the first stages of cooperation projects during the lifetime of the TANDEM project and lay solid foundations for long-term cooperation; relay local authorities' claims and concerns at both national and European levels, aimed at providing them with greater latitude and freedom of action. Approaches specific to each country have been developed to promote energy transition at the local level. A comparative analysis of existing practices, tools and experiences involving research work and interviews will be conducted and made available to the participating authorities as well as to national organisations. This analysis will be used by national organisations to develop and enhance their action and by local authorities to improve mutual understanding during their discussions. Cooperation projects aimed at implementing energy

Defining Multidrug Resistance of Gram-Negative Bacteria in the Dutch-German Border Region-Impact of National Guidelines.

Science.gov (United States)

Köck, Robin; Siemer, Philipp; Esser, Jutta; Kampmeier, Stefanie; Berends, Matthijs S; Glasner, Corinna; Arends, Jan P; Becker, Karsten; Friedrich, Alexander W

2018-01-26

Preventing the spread of multidrug-resistant Gram-negative bacteria (MDRGNB) is a public health priority. However, the definition of MDRGNB applied for planning infection prevention measures such as barrier precautions differs depending on national guidelines. This is particularly relevant in the Dutch-German border region, where patients are transferred between healthcare facilities located in the two different countries, because clinicians and infection control personnel must understand antibiograms indicating MDRGNB from both sides of the border and using both national guidelines. This retrospective study aimed to compare antibiograms of Gram-negative bacteria and classify them using the Dutch and German national standards for MDRGNB definition. A total of 31,787 antibiograms from six Dutch and four German hospitals were classified. Overall, 73.7% were no MDRGNB according to both guidelines. According to the Dutch and German guideline, 7772/31,787 (24.5%) and 4586/31,787 (12.9%) were MDRGNB, respectively ( p Dutch-German border, as it cannot be assumed that MDRGNB requiring special hygiene precautions are marked in the transferred antibiograms in accordance with both national guidelines.

Physicians' occupational stress, depressive symptoms and work ability in relation to their working environment: a cross-sectional study of differences among medical residents with various specialties working in German hospitals.

Science.gov (United States)

Bernburg, Monika; Vitzthum, Karin; Groneberg, David A; Mache, Stefanie

2016-06-15

This study aimed to analyse and compare differences in occupational stress, depressive symptoms, work ability and working environment among residents working in various medical specialties. 435 German hospital residents in medical training working in 6 different medical specialties participated in a cross-sectional survey study. Physicians were asked about their working conditions and aspects of mental health and work ability. The Copenhagen Psychosocial Questionnaire, the Work Ability Index, the ICD-10 Symptom Rating and the Perceived Stress Questionnaire were used to measure working conditions, mental health and work ability. Results show that up to 17% of the physicians reported high levels of occupational distress and 9% reported high levels of depressive symptoms. 11% of the hospital physicians scored low in work ability. Significant differences between medical specialties were demonstrated for occupational distress, depressive symptoms, work ability, job demands and job resources. Surgeons showed consistently the highest levels of perceived distress but also the highest levels of work ability and lowest scores for depression. Depressive symptoms were rated with the highest levels by anaesthesiologists. Significant associations between physicians' working conditions, occupational distress and mental health-related aspects are illustrated. Study results demonstrated significant differences in specific job stressors, demands and resources. Relevant relations between work factors and physicians' health and work ability are discussed. These findings should be reinvestigated in further studies, especially with a longitudinal study design. This work suggests that to ensure physicians' health, hospital management should plan and implement suitable mental health promotion strategies. In addition, operational efficiency through resource planning optimisation and work process improvements should be focused by hospital management. Published by the BMJ Publishing Group

Explanatory models of addictive behaviour among native German, Russian-German, and Turkish youth.

Science.gov (United States)

Penka, S; Heimann, H; Heinz, A; Schouler-Ocak, M

2008-01-01

In Germany, the public system of addiction treatment is used less by migrants with addictive disorders than by their non-migrant counterparts. To date, the literature has focused primarily on language, sociocultural factors, and residence status when discussing access barriers to this part of the health care system. However, little attention has been paid to cultural differences in explanatory models of addictive behaviour. This is surprising when we consider the important role played by popular knowledge in a population's perceptions of and responses to illnesses, including their causes, symptoms, and treatment. In the present study, we examined explanatory models of addictive behaviour and of mental disorders in 124 native German und Russian-German youth and compared these models to those observed in an earlier study of 144 German and Turkish youth. We employed the free listing technique German and to compile the terms that participating subjects used to describe addictive behaviour. Subsequently, we examined how a subset of our study population assigned these terms to the respective disorders by means of the pile sort method. Although the explanatory models used by the German and Russian-German youth in our study were surprisingly similar, those employed by Turkish youth did not make any fundamental distinction between illegal and legal drugs (e.g. alcohol and nicotine). German and Russian-German youth regarded eating disorders as "embarrassing" or "disgraceful", but Turkish youth did not. Unlike our German and Russian-German subjects, the Turkish youth did not classify eating disorders as being addictive in nature. Moreover, medical concepts crucial to a proper understanding of dependence disorders (e.g. the term "physical dependence") were characterised by almost half of our Turkish subjects as useless in describing addictions. These findings show that it is impossible to translate medical or everyday concepts of disease and treatment properly into a different

[From traditional to modern hospital--from Paris to Berlin].

Science.gov (United States)

Murken, Axel Hinrich

Discussions about the modernisation and reform of the Hôtel Dieu in Paris concerning the catastrophic fire of 1772 there were followed very closely in Prussia and other German countries, though for a long time this had only slight consequences for modernising developments in the hospitals of Berlin or other administrative capitals of Germany. In contrast to this, the Hôpital Lariboisière was praised as a model example in Germany soon after its completion in 1854 after the pre-revolutionary Parisian plans, was imitated in Berlin twenty years later. It must be added that in Prussia great importance was attached to stricter requirements for hygiene and ventilation than in Paris. This was clearly demonstrated barely in the construction of the pavilionhospital in Berlin-Friedrichshain (1868-1874) with an extremely decentralized layout. It was not until two generations later with the completion of the municipal hospital Westend in Charlottenburg (1904-1907), a suburb of Berlin, that a slightly modified "Lariboisière" in the Wilheminian brick Baroque style was built. Similarily the acceptance of high-rise construction was, compared with Paris, considerably delayed on the German hospital scene. Whereas in the USA and France plans had been made for high-rise hospitals from the 1920s on and realized by 1935, as with the Hôpital Beaujon in Paris (1932-1935), there were fundamental reservations about them in Germany. As a result, this conception of the structure, with an effective concentration of inpatient care in towers together with separate low-rise buildings for functions such as treatment and diagnosis, only gradually gained acceptance in Germany at the end of the 1960s. On the other hand, German architects such as Hermann Distel (1875-1946) or Ernst Kopp (1890-1962), had already, indeed before the Second World War, promoted the high-rise type for inpatient care on theoretical grounds. In addition, two hospitals providing medical care within in Berlin, Martin

[Physical activity: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

Science.gov (United States)

Krug, S; Jordan, S; Mensink, G B M; Müters, S; Finger, J; Lampert, T

2013-05-01

Regular physical activity can have a positive effect on health at any age. Today's lifestyles, however, can often be characterised as sedentary. Therefore, the promotion of physical activity and sports has become an integral part of public health measures. The representative data of adults aged 18 to 79 years in Germany obtained from the "German Health Interview and Examination Survey for Adults" (DEGS1) provide an overview of self-estimated current physical activity behaviour. The results show that one third of the adult population claims to pay close attention to reaching a sufficient level of physical activity and one fourth participates in sports for at least 2 h/week on a regular basis. Thus, the percentage of adults regularly engaged in sports has increased compared to the previous "German National Health Interview and Examination Survey 1998". Still, four out of five adults do not achieve at least 2.5 h/week of moderate-intensity physical activity as recommended by the World Health Organisation. Consequently, future individual-level and population-level interventions should focus on target group-specific measures while continuing to promote regular physical activity in all segments of the population. An English full-text version of this article is available at SpringerLink as supplemental.

Economies of scale and optimal size of hospitals: Empirical results for Danish public hospitals

DEFF Research Database (Denmark)

Kristensen, Troels

number of beds per hospital is estimated to be 275 beds per site. Sensitivity analysis to partial changes in model parameters yields a joint 95% confidence interval in the range 130 - 585 beds per site. Conclusions: The results indicate that it may be appropriate to consolidate the production of small...... the current configuration of Danish hospitals is subject to scale economies that may justify such plans and to estimate an optimal hospital size. Methods: We estimate cost functions using panel data on total costs, DRG-weighted casemix, and number : We estimate cost functions using panel data on total costs......, DRG-weighted casemix, and number of beds for three years from 2004-2006. A short-run cost function is used to derive estimates of long-run scale economies by applying the envelope condition. Results: We identify moderate to significant long-run economies of scale when applying two alternative We...

Sibling Rivalry in Educational Attainment: The German Case

OpenAIRE

Ira N. Gang; Thomas Bauer

2000-01-01

Recent studies exploring sibling rivalry in the allocation of household resources in the U.S. produce conflicting results. We contribute to this discussion by addressing the role of sibling rivalry in educational attainment in Germany. Using the German Socioeconomic Panel (GSOEP) we are able to distinguish how the effects of sibling rivalry vary by cultural affiliation, i.e., among families of West German, East German and foreign origin. We also point out and correct for a reference group pro...

"These forecasts may be substantially different from actual results." The use of epistemic modal markers in English and German original letters to shareholders and in English-German translations*

Directory of Open Access Journals (Sweden)

Andrea Bicsár

2012-01-01

Full Text Available Letters to shareholders (i. e. the first part of a company's Annual Report represent an interesting genre for the analysis of epistemic modal expressions. They serve the function to present a short overview of the company's main achievements as well as an outlook into the future. They additionally serve a more marketing-oriented goal: to inspire confidence in the company. Epistemic modal expressions (e. g. may, perhaps, probably are used in texts for two main reasons: Firstly, speakers can signal with these markers that they have content-based reasons to be unsure about the states of affairs they are talking about. This type of use can be expected to be typical in the context of predictions of future developments. Secondly, speakers can use them for interpersonal reasons, to open up the discursive space for alternative positions, leaving the readers their right to form their own opinion. This type of use can be expected in positive evaluations of one’s own company, which are thus presented in a mitigated way, avoiding the impression of boasting.It is in particular the second type of use that can be expected to be highly sensitive to cultural differences. The present paper analyzes to what extent US-English and German letters to shareholders differ in the use of these markers, and how these differences are reflected in English-German translations. Our quantitative analysis of the distribution of all epistemic modal markers in a multilingual corpus comes to the conclusion that there are notable differences between English and German original texts. Unlike in other studies on English-German translations (e. g. Kranich/House/Becher 2012, however, we arrive at the conclusion that the English-German translations are very closely adapted to the target-language conventions and show little interference from the English originals.

DEMorphy, German Language Morphological Analyzer

OpenAIRE

Altinok, Duygu

2018-01-01

DEMorphy is a morphological analyzer for German. It is built onto large, compactified lexicons from German Morphological Dictionary. A guesser based on German declension suffixed is also provided. For German, we provided a state-of-art morphological analyzer. DEMorphy is implemented in Python with ease of usability and accompanying documentation. The package is suitable for both academic and commercial purposes wit a permissive licence.

Management changes resulting from hospital accreditation.

Science.gov (United States)

Oliveira, João Lucas Campos de; Gabriel, Carmen Silvia; Fertonani, Hosanna Pattrig; Matsuda, Laura Misue

2017-03-02

to analyze managers and professionals' perceptions on the changes in hospital management deriving from accreditation. descriptive study with qualitative approach. The participants were five hospital quality managers and 91 other professionals from a wide range of professional categories, hierarchical levels and activity areas at four hospitals in the South of Brazil certified at different levels in the Brazilian accreditation system. They answered the question "Tell me about the management of this hospital before and after the Accreditation". The data were recorded, fully transcribed and transported to the software ATLAS.ti, version 7.1 for access and management. Then, thematic content analysis was applied within the reference framework of Avedis Donabedian's Evaluation in Health. one large family was apprehended, called "Management Changes Resulting from the Accreditation: perspectives of managers and professionals" and five codes, related to the management changes in the operational, structural, financial and cost; top hospital management and quality management domains. the management changes in the hospital organizations resulting from the Accreditation were broad, multifaceted and in line with the improvements of the service quality. analizar las percepciones de gestores y trabajadores sobre los cambios en la gestión hospitalaria resultantes de la Acreditación. estudio descriptivo con aproximación cualitativa. Participaron cinco gestores de calidad hospitalaria y otros 91 trabajadores de las más diversas categorías profesionales, niveles jerárquicos y áreas de actuación de cuatro hospitales del sur de Brasil certificados por la Acreditación nacional de diferentes niveles, que contestaron la pregunta "Cuéntame sobre la gestión de este hospital, antes y después de la Acreditación". Los datos fueron grabados, transcritos por completo y transportados para acceso y manoseo en el software ATLAS.ti, versión 7.1. A seguir, fue aplicado el análisis de

Three essays on regulated markets. Renewable energies, hospital competition and health insurance

Energy Technology Data Exchange (ETDEWEB)

Unfried, Matthias

2012-11-15

This doctoral thesis presents an analysis of regulated markets especially focusing on the behavior of the actors, the effects of regulatory interventions on market outcome, and the necessity of the regulation itself. With respect to the particular characteristics, three different markets are analyzed: the German market for photovoltaic capacity, the German hospital sector, and the market for health insurance with respect to outpatient care. Chapter two provides an analysis of the German system of feed-in tariffs for photovoltaic power with respect to effectiveness and efficiency. To ensure a certain volume of investment in photovoltaic capacity investors receive fixed feed-in tariffs for 20 years for each unit of energy they feed into the grid. This remuneration is reduced according to a certain cut-off scheme for devices which will be installed in the future. In the past view years, an enormous volume of photovoltaic devices has been installed, especially in the weeks before the cut-offs. To analyze the efficiency and the effectiveness of the German feed-in tariff system, first, the determinants of such investment are analyzed by estimating an Error Correction model. The results of the estimation are used to simulate alternative mechanisms of adjusting the feed-in tariffs and compare them to the current regime in terms of target achievement and social costs. One of the key results is that the current system causes early investments, but does not induce over-investment. Moreover, it is shown that a system of continuously adjusted feed-in tariffs could be more appropriate than the current regime and that the adjustment should be related to the investment costs. In chapter three, the German hospital market which is characterized by regulated treatment fees and several different ownership types is analyzed. This part of the thesis tries to answer the question how the existence of non-profit hospitals influences market outcome and welfare compared to a market where

Health Information in German (Deutsch)

Science.gov (United States)

... Tools You Are Here: Home → Multiple Languages → German (Deutsch) URL of this page: https://medlineplus.gov/languages/german.html Health Information in German (Deutsch) To use the sharing features on this page, ...

[Employee satisfaction in hospitals - validation of the Picker employee questionnaire: the German version of the "survey of employee perceptions of health care delivery" (Picker Institute Boston)].

Science.gov (United States)

Riechmann, M; Stahl, K

2013-05-01

The aim of this study was the validation of a questionnaire specially developed for the German health-care market to measure workplace-related satisfaction of all employees in direct or indirect contact to patients. Beside this, its suitability for use in human resource and quality management was tested. Based on data from a postal survey of 38 054 employees from 37 hospitals a psychometric evaluation was done via exploratory factor analysis and reliability as well as regression analysis. For testing the capability to differentiate, subgroup analyses were conducted. 14 factors (Cronbach's alpha between 0.6 and 0.9) were extracted, explaining 44% of the variance. The factors leadership and organisational culture, conditions of employment, work load and relationship to direct line manager had the strongest influence on overall employee satisfaction. Age, gender, employment status, and senior position influence job satisfaction or relevant satisfaction-related factors. Psychometric properties, the ability to differentiate between employee groups and practicability render the questionnaire well suited for use in human resource and quality management of hospitals. © Georg Thieme Verlag KG Stuttgart · New York.

Stop and Fricative Devoicing in European Portuguese, Italian and German.

Science.gov (United States)

Pape, Daniel; Jesus, Luis M T

2015-06-01

This paper describes a cross-linguistic production study of devoicing for European Portuguese (EP), Italian, and German. We recorded all stops and fricatives in four vowel contexts and two word positions. We computed the devoicing of the time-varying patterns throughout the stop and fricative duration. Our results show that regarding devoicing behaviour, EP is more similar to German than Italian. While Italian shows almost no devoicing of all phonologically voiced consonants, both EP and German show strong and consistent devoicing through the entire consonant. Differences in consonant position showed no effect for EP and Italian, but were significantly different for German. The height of the vowel context had an effect for German and EP. For EP, we showed that a more posterior place of articulation and low vowel context lead to significantly more devoicing. However, in contrast to German, we could not find an influence of consonant position on devoicing. The high devoicing for all phonologically voiced stops and fricatives and the vowel context influence are a surprising new result. With respect to voicing maintenance, EP is more like German than other Romance languages.

Efficiency, ownership, and financing of hospitals: the case of Austria.

Science.gov (United States)

Czypionka, Thomas; Kraus, Markus; Mayer, Susanne; Röhrling, Gerald

2014-12-01

While standard economic theory posits that privately owned hospitals are more efficient than their public counterparts, no clear conclusion can yet be drawn for Austria in this regard. As previous Austrian efficiency studies rely on data from the 1990s only and are based on small hospital samples, the generalizability of these results is questionable. To examine the impact of ownership type on efficiency, we apply a Data Envelopment Analysis which extends the existing literature in two respects: first, it evaluates the efficiency of the Austrian acute care sector, using data on 128 public and private non-profit hospitals from the year 2010; second, it additionally focusses on the inpatient sector alone, thus increasing the comparability between hospitals. Overall, the results show that in Austria, private non-profit hospitals outperform public hospitals in terms of technical efficiency. A multiple regression analysis confirms the significant association between efficiency and ownership type. This conclusive result contrasts some international evidence and can most likely be attributed to differences in financial incentives for public and private non-profit hospitals in Austria. Therefore, by drawing on the example of the Austrian acute care hospital sector and existing literature on the German acute care hospital sector, we also discuss the impact of hospital financing systems and their incentives on efficiency. This paper thus also aims at providing a proof of principle, pointing out the importance of the respective market conditions when internationally comparing hospital efficiency by ownership type.

Yoga Therapy in the German Healthcare System.

Science.gov (United States)

Cramer, Holger

2018-05-09

An estimated 15.7 million Germans are currently practicing yoga or are at least interested in starting to practice, and they often perceive yoga as a therapeutic approach. From a healthcare system perspective, the situation is less clear. Here, yoga is only recognized as a recreational or preventive activity. When yoga teachers fulfill specific qualifications, their preventive yoga classes are covered by the statutory health insurances. Only those with additional qualifications in medicine or psychotherapy, however, can independently use and promote "yoga therapy." The general perception of yoga in Germany as a preventive practice is reflected in the professional organization of yoga providers. Most providers are considered to be yoga teachers rather than yoga therapists and are organized mainly in yoga teacher associations. Despite the uncertain legal framework, yoga is now considered in a number of medical guidelines; in a number of hospitals, yoga is part of multimodal inpatient treatment programs and is delivered by physical therapists or members of other health professions. An increasing number of yoga therapy clinical trials are conducted in Germany, and efforts are underway to establish yoga therapy as an accepted adjunct treatment approach for selected medical conditions within the German healthcare system.

DDR-Landeskundliches im Deutschunterricht (East German Culture in the German Lesson).

Science.gov (United States)

Wazel, Gerhard

1988-01-01

Demonstrates with concrete examples from the texts of a German class for advanced learners how aspects of East German culture can be realized in vocabulary, in lectures, and in the development of listening comprehension and speaking skills. Texts are appended. (DJD)

[Factors affecting in-hospital mortality in patients with sepsis: Development of a risk-adjusted model based on administrative data from German hospitals].

Science.gov (United States)

König, Volker; Kolzter, Olaf; Albuszies, Gerd; Thölen, Frank

2018-05-01

Inpatient administrative data from hospitals is already used nationally and internationally in many areas of internal and public quality assurance in healthcare. For sepsis as the principal condition, only a few published approaches are available for Germany. The aim of this investigation is to identify factors influencing hospital mortality by employing appropriate analytical methods in order to improve the internal quality management of sepsis. The analysis was based on data from 754,727 DRG cases of the CLINOTEL hospital network charged in 2015. The association then included 45 hospitals of all supply levels with the exception of university hospitals (range of beds: 100 to 1,172 per hospital). Cases of sepsis were identified via the ICD codes of their principal diagnosis. Multiple logistic regression analysis was used to determine the factors influencing in-hospital lethality for this population. The model was developed using sociodemographic and other potential variables that could be derived from the DRG data set, and taking into account current literature data. The model obtained was validated with inpatient administrative data of 2016 (51 hospitals, 850,776 DRG cases). Following the definition of the inclusion criteria, 5,608 cases of sepsis (2016: 6,384 cases) were identified in 2015. A total of 12 significant and, over both years, stable factors were identified, including age, severity of sepsis, reason for hospital admission and various comorbidities. The AUC value of the model, as a measure of predictability, is above 0.8 (H-L test p>0.05, R 2 value=0.27), which is an excellent result. The CLINOTEL model of risk adjustment for in-hospital lethality can be used to determine the mortality probability of patients with sepsis as principal diagnosis with a very high degree of accuracy, taking into account the case mix. Further studies are needed to confirm whether the model presented here will prove its value in the internal quality assurance of hospitals

Error Patterns in Young German Children's "Wh"-Questions

Science.gov (United States)

Schmerse, Daniel; Lieven, Elena; Tomasello, Michael

2013-01-01

In this article we report two studies: a detailed longitudinal analysis of errors in "wh"-questions from six German-learning children (age 2 ; 0-3 ; 0) and an analysis of the prosodic characteristics of "wh"-questions in German child-directed speech. The results of the first study demonstrate that German-learning children…

Investigation of the influence of modified parameters in the atmospheric dispersion model on the results of the German Risk Study (DRS)

International Nuclear Information System (INIS)

Vogt, S.; Wittek, P.

1982-04-01

A substantial criterion in preparing Phase A of the German Risk Study was its comparability with the U. S. Reactor Safety Study. Therefore, a number of basic assumptions and methodological principles were to be identical with those adopted in the American study. For Phase B of the German Risk Study improvements of the method will be used to a greater extent and recent results of research work taken into account. A first step in this direction will consists in investigating the influence exerted by modified parameters in the dispersion submodel. The other parameters, besides dry and wet deposition, are the height of the mixing layer, the dispersion parameters and the wind direction. Furthermore, the degree will be studied at which the selection of weather sequences have an influence on the collective risks. All results indicated will be related to the results obtained in Phase A. (orig.) [de

Biliary atresia: lessons learned from the voluntary German registry.

Science.gov (United States)

Leonhardt, J; Kuebler, J F; Leute, P J; Turowski, C; Becker, T; Pfister, E-D; Ure, B; Petersen, C

2011-03-01

Aim of the study was to carry out a 5-year survey of German patients with biliary atresia (BA) and to launch a discussion regarding the feasibility of voluntary registries in unregulated healthcare systems. A retrospective analysis of German BA patients born between 2001 and 2005, based on data collected from the voluntary European Biliary Atresia Registry (EBAR), was carried out and supplemented by data from all BA patients who underwent liver transplantation at the only 4 pediatric transplantation centers (pLTx) in Germany which are so far not registered at EBAR. Survival rates were calculated using Kaplan-Meier analysis and compared by Cox regression to determine the predictive value of age at surgery and the influence of the center size (fewer or more than 5 patients/study period) on overall survival and survival with native liver. A critical review of the 148 German EBAR charts revealed that 11 patients (7.4%) had no biliary atresia. The remaining 137 patients from EBAR together with 46 BA patients who underwent LTx without prior registration at EBAR were evaluated with a median follow-up of 39 months (range: 25-85 months). 29 hospitals performed a total of 159 Kasai procedures, but only 7 centers treated 5 or more patients (116 patients, range: 5-68), and 22 hospitals performed less than 5 KP (43 patients, range: 1-4). Primary LTx was performed in 21 patients (11.5%) and 3 patients died without surgical intervention. 16 patients were lost to follow-up (8.7%). Overall survival after 2 years was 83.3% (139 patients), including 105 patients (63%) who had undergone LTx and 34 patients (20.3%) with native liver. 28 patients died (16.7%), 8 after LTx (5.8%). The experience of the center was the only factor with a significant predictive value for jaundice-free survival with native liver (p=0.001). 25% of all German BA patients were not registered at EBAR, and 29 clinics were involved in the surgical management of BA patients. Therefore a new approach consisting of

Is the Internet a useful and relevant source for health and health care information retrieval for German cardiothoracic patients? First results from a prospective survey among 255 Patients at a German cardiothoracic surgical clinic

Directory of Open Access Journals (Sweden)

Diez Claudius

2006-10-01

Full Text Available Abstract Background It is not clear how prevalent Internet use among cardiopathic patients in Germany is and what impact it has on the health care utilisation. We measured the extent of Internet use among cardiopathic patients and examined the effects that Internet use has on users' knowledge about their cardiac disease, health care matters and their use of the health care system. Methods We conducted a prospective survey among 255 cardiopathic patients at a German university hospital. Results Forty seven respondents (18 % used the internet and 8,8 % (n = 23 went online more than 20 hours per month. The most frequent reason for not using the internet was disinterest (52,3 %. Fourteen patients (5,4 % searched for specific disease-related information and valued the retrieved information on an analogous scale (1 = not relevant, 5 = very relevant on median with 4,0. Internet use is age and education dependent. Only 36 (14,1 % respondents found the internet useful, whereas the vast majority would not use it. Electronic scheduling for ambulatory visits or postoperative telemedical monitoring were rather disapproved. Conclusion We conclude that Internet use is infrequent among our study population and the search for relevant health and disease related information is not well established.

Safety and safeguards aspects on retrievability: A German study

International Nuclear Information System (INIS)

Biurrun, E.; Engelmann, H.-J.; Brennecke, P.; Kranz, H.

2000-01-01

The article refers shortly to the definition of the term 'retrievability' and shows two different possibilities of retrieval scenarios, their advantages and detriments. The second part lists the Safeguards aspects of retrievability, gives a short outlook on the present German Safeguards Reference Concept in the post-closure phase of a repository in a salt dome and about the results of German studies concerning some proposed Safeguards methods. Furthermore, Planned investigations on Safeguards in the post-closure phase of a repository are mentioned. The third and main part finally describes the results of the German Retrievability Study, which was elaborated in the middle of the nineties by DBE on behalf of the German Federal Ministry of Education, Science, Research and Technology, BMBF, under an R and D contract. (author)

[German influences on Romanian medical terminology].

Science.gov (United States)

Răcilă, R G; Răileanu, Irena; Rusu, V

2008-01-01

The medical terminology plays a key part both in the study of medicine as well as in its practice. Moreover, understanding the medical terms is important not only for the doctor but also for the patients who want to learn more about their condition. For these reasons we believe that the study of medical terminology is one of great interest. The aim of our paper was to evaluate the German linguistic and medical influences on the evolution of the Romanian medical terminology. Since the Romanian-German cultural contacts date back to the 12th century we had reasons to believe that the number of German medical words in Romanian would be significant. To our surprise, the Romanian language has very few German words and even less medical terms of German origin. However, when we searched the list of diseases coined after famous medical personalities, we found out that 26 % of them bore the names of German doctors and scientists. Taken together this proves that the German medical school played an important role on the evolution of Romanian medicine despite the fact that the Romanian vocabulary was slightly influenced by the German language. We explain this fact on the structural differences between the Romanian and German languages, which make it hard for German loans to be integrated in the Romanian lexis. In conclusion we state that the German influence on the Romanian medical terminology is weak despite the important contribution of the German medical school to the development of medical education and healthcare in Romania. Key

Attitudes Concerning Postmortem Organ Donation: A Multicenter Survey in Various German Cohorts.

Science.gov (United States)

Uhlig, Constantin E; Böhringer, Daniel; Hirschfeld, Gerrit; Seitz, Berthold; Schmidt, Hartmut

2015-10-13

The aim of this study was to characterize postmortem organ donation attitudes in various German cohorts. Employees of 2 German cities and 2 German university hospitals, employees of a German automobile enterprise, and members of a German Medical Society were administered a questionnaire about postmortem organ and tissue donation attitudes. Demographic data and general attitudes were questioned and focused on: I) willingness to donate organs, II) holding a donor card, and III) having discussed the topic with the family. Of 5291 participants, 65.2% reported favoring postmortem organ donation. Missing negative experiences, the idea that donation is helpful, a non-medical professional environment, excellent general health, gender, agreement with the brain-death paradigm, and age significantly influenced the participants' attitudes. Participants were more likely to possess donor cards and had discussed more often with family members if they agreed with the brain-death paradigm and considered donation to be helpful. Males and older participants were the most likely to neglect donor cards, and Catholics, Protestants, and participants with poor health were the least likely to donate organs. Interest in receiving more information was expressed by 38.1% and 50.6% of participants refusing donation of all or of specific organs, respectively, and suggested the internet (60.0%) and family doctors (35.0%) as preferred sources of information. Public campaigns in Germany should focus on males and older people as regards donor cards, and females, younger, and religiously affiliated persons as regards the general willingness to donate organs postmortem.

Generic results and conclusions of re-evaluating the flooding protection in French and German nuclear power plants

International Nuclear Information System (INIS)

Mattei, J.M.; Vial, E.; Rebour, V.

2001-01-01

Although the event which occurred at the Blayais site on December 27, 1999 did not lead to a dangerous situation for the local population or the environment, it clearly demonstrated the possible occurrence of modes of degradation of the safety level affecting all the units at a site. As a result, a number of projects were established by the French and German operators that were designed to extract useful lessons concerning the flooding risks at the Blayais site, as well as to upgrade all sites equipped with pressurized water reactors, both in France and Germany. This report presents, on the basis of the circumstances observed at the Blayais site during the course of the flood event of December 27, 1999 (which was the subject of a presentation by IPSN at the Eurosafe 2000 Conference), an evaluation of the initiatives aimed at improving the safety of both the French and the German units from an external flooding risk perspective. The safety approaches used in both countries have not been compared. (authors)

Generic results and conclusions of re-evaluating the flooding protection in French and German nuclear power plants

Energy Technology Data Exchange (ETDEWEB)

Mattei, J.M.; Vial, E.; Rebour, V. [CEA Fontenay-aux-Roses, 92 (France). Inst. de Protection et de Surete Nucleaire; Liemersdorf, H.; Tuerschmann, M. [Gesellschaft fuer Anlagen- und Reaktorsicherheit (GRS) mbH, Garching (Germany)

2001-07-01

Although the event which occurred at the Blayais site on December 27, 1999 did not lead to a dangerous situation for the local population or the environment, it clearly demonstrated the possible occurrence of modes of degradation of the safety level affecting all the units at a site. As a result, a number of projects were established by the French and German operators that were designed to extract useful lessons concerning the flooding risks at the Blayais site, as well as to upgrade all sites equipped with pressurized water reactors, both in France and Germany. This report presents, on the basis of the circumstances observed at the Blayais site during the course of the flood event of December 27, 1999 (which was the subject of a presentation by IPSN at the Eurosafe 2000 Conference), an evaluation of the initiatives aimed at improving the safety of both the French and the German units from an external flooding risk perspective. The safety approaches used in both countries have not been compared. (authors)

Predictive validity of the identification of seniors at risk screening tool in a German emergency department setting.

Science.gov (United States)

Singler, Katrin; Heppner, Hans Jürgen; Skutetzky, Andreas; Sieber, Cornel; Christ, Michael; Thiem, Ulrich

2014-01-01

The identification of patients at high risk for adverse outcomes [death, unplanned readmission to emergency department (ED)/hospital, functional decline] plays an important role in emergency medicine. The Identification of Seniors at Risk (ISAR) instrument is one of the most commonly used and best-validated screening tools. As to the authors' knowledge so far there are no data on any screening tool for the identification of older patients at risk for a negative outcome in Germany. To evaluate the validity of the ISAR screening tool in a German ED. This was a prospective single-center observational cohort study in an ED of an urban university-affiliated hospital. Participants were 520 patients aged ≥75 years consecutively admitted to the ED. The German version of the ISAR screening tool was administered directly after triage of the patients. Follow-up telephone interviews to assess outcome variables were conducted 28 and 180 days after the index visit in the ED. The primary end point was death from any cause or hospitalization or recurrent ED visit or change of residency into a long-term care facility on day 28 after the index ED visit. The mean age ± SD was 82.8 ± 5.0 years. According to ISAR, 425 patients (81.7%) scored ≥2 points, and 315 patients (60.5%) scored ≥3 points. The combined primary end point was observed in 250 of 520 patients (48.1%) on day 28 and in 260 patients (50.0%) on day 180. Using a continuous ISAR score the area under the curve on day 28 was 0.621 (95% confidence interval, CI 0.573-0.669) and 0.661 (95% CI 0.615-0.708) on day 180, respectively. The German version of the ISAR screening tool acceptably identified elderly patients in the ED with an increased risk of a negative outcome. Using the cutoff ≥3 points instead of ≥2 points yielded better overall results.

[Sample German LAPS.

Science.gov (United States)

Rosenthal, Bianca

Four learning activity packages (LAPS) for use in secondary school German programs contain instructional materials which enable students to improve their basic linguistic skills. The units include: (1) "Grusse," (2) "Ich Heisse...Namen," (3) "Tune into Your Career: Business Correspondence 'Auf Deutch'," and (4) "Understanding German Culture."…

Organizational rationality, performance, and social responsibility: results from the hospital industry.

Science.gov (United States)

Becker, Edmund R; Potter, Sharyn J

2002-01-01

Drawing on stakeholder theory and Weber's distinction between formal and substantive rationality, we posit that: (1) for-profit organizations manage stakeholders in ways that result in the organization being more efficient and less socially responsible than organizations that are not as profit oriented, and (2) organizations with major corporate relationships that are not local manage stakeholders in a manner that results in the organization being more efficient and less socially responsible than organizations without such arrangements. We test these hypotheses with 1994 data on 4,705 of the nation's short-term general hospitals using two measures of hospital efficiency and four measures of social responsibility. Results confirm that for-profit hospitals and hospitals lacking local ties are managing stakeholder relationships in ways that increases the efficiency of these hospitals but decreases their social responsiveness. We conclude by speculating that organizational efficiency and social responsibility may be inversely related and then summarize some of the academic, managerial, and policy implications, with emphasis on the implications for stakeholder theory.

Accent, Intelligibility, and the Role of the Listener: Perceptions of English-Accented German by Native German Speakers

Science.gov (United States)

Hayes-Harb, Rachel; Watzinger-Tharp, Johanna

2012-01-01

We explore the relationship between accentedness and intelligibility, and investigate how listeners' beliefs about nonnative speech interact with their accentedness and intelligibility judgments. Native German speakers and native English learners of German produced German sentences, which were presented to 12 native German speakers in accentedness…

[Private charity - public health service. Comparison between British and German birthing centers of the 18th century].

Science.gov (United States)

Schlumbohm, Jürgen

In the eighteenth century, lying-in hospitals were founded in many European towns and cities. The way in which these institutions were financed differed greatly across Europe. In the UK, most of them were "charities" and relied on donations from wealthy benefactors, whereas on the continent they were usually funded by "public" money, be it from the state or local communities. The paper focuses on British charities and German hospitals, and explores the corollaries of the mode of financing. In the eighteenth century, a market emerged in Britain where numerous charities with different aims competed for donations from the well-to-do. For attracting benefactors, a charity had to convince potential donors that its clientele and purpose were particularly deserving, and that it used the money donated in a cost-efficient way. In Germany, it was mainly bureaucrats and governments who had to be persuaded, but public opinion did matter as well. In British lying-in charities, the main donors acted as governors, and benefactors could recommend persons for being admitted. In publicly funded German hospitals, the medical directors had much more power. In the competitive market, in which British charities acted, out-patient dispensaries (policlinics) became increasingly important, since they could argue that they were more cost-efficient and had lower mortality. In Germany, however, hospitals remained the dominant type of assistance in this field, in spite of the criticism they received. The different sources of finance appear to have been one of the reasons for this divergence. Teaching was the main purpose of most German lying-in hospitals. They either trained medical students or midwife apprentices or both. Since the patients served as teaching objects, all women were welcomed, and in fact most patients were single mothers. By contrast, most of the British institutions admitted only married women, because donors did not wish to encourage immorality. The charities staged the

Health-Related Quality of Life of the General German Population in 2015: Results from the EQ-5D-5L.

Science.gov (United States)

Huber, Manuel B; Felix, Julia; Vogelmann, Martin; Leidl, Reiner

2017-04-16

The EQ-5D-5L is a widely used generic instrument to measure health-related quality of life. This study evaluates health perception in a representative sample of the general German population from 2015. To compare results over time, a component analysis technique was used that separates changes in the description and valuation of health states. The whole sample and also subgroups, stratified by sociodemographic parameters as well as disease affliction, were analyzed. In total, 2040 questionnaires (48.4% male, mean age 47.3 year) were included. The dimension with the lowest number of reported problems was self-care (93.0% without problems), and the dimension with the highest proportion of impairment was pain/discomfort (71.2% without problems). Some 64.3% of the study population were identified as problem-free. The visual analog scale (VAS) mean for all participants was 85.1. Low education was connected with significantly lower VAS scores, but the effect was small. Depression, heart disease, and diabetes had a strong significant negative effect on reported VAS means. Results were slightly better than those in a similar 2012 survey; the most important driver was the increase in the share of the study population that reported to be problem-free. In international comparisons, health perception of the general German population is relatively high and, compared with previous German studies, fairly stable over recent years. Elderly and sick people continue to report significant reductions in perceived health states.

[Dementia friendly care services in general hospitals : Representative results of the general hospital study (GHoSt)].

Science.gov (United States)

Hendlmeier, Ingrid; Bickel, Horst; Hessler, Johannes Baltasar; Weber, Joshua; Junge, Magdalena Nora; Leonhardt, Sarah; Schäufele, Martina

2017-11-06

Mostly model projects report on special care services and procedures for general hospital patients with cognitive impairment. The objective of this study was to determine the frequency of special care services and procedures in general hospitals on the basis of a representative cross-sectional study. From a list of all general hospitals in southern Germany we randomly selected a specified number of hospitals und somatic wards. The hospitals were visited and all older patients on the selected wards on that day were included in the study. Information about care services and their utilization was collected with standardized instruments. A total of 33 general hospitals and 172 wards participated in the study. The patient sample included 1469 persons over 65 (mean age 78.6 years) and 40% of the patients showed cognitive impairments. The staff reported that the most frequent measures for patients with cognitive impairments concerned patients with wandering behavior (63.1%), efforts to involve the patients' relatives to help with their daily care (60.1%), conducting nonintrusive interviews to identify cognitive impairments (59.9%), allocation to other rooms (58%) and visual aids for place orientation of patients (50.6%). In accordance with earlier studies our results show that other dementia friendly services implemented in pilot projects were rare. The existing special services for patients with cognitive impairment were rarely used by the patients or their relatives. The results demonstrate the urgent need to improve special care services and routines for identification of elderly patients with cognitive impairment and risk of delirium in general hospitals.

German Orientalism

OpenAIRE

Margaret Olin

2011-01-01

Review of: Suzanne L. Marchand, German Orientalism in the Age of Empire: Religion, Race and Scholarship, Cambridge and Washington, D.C.: Cambridge University Press, 2009. This analysis of Suzanne L. Marchand’s German Orientalism in the Age of Empire: Religion, Race and Scholarship reads her contribution in part against the background of Edward Said’s path breaking book Orientalism. Differences lie in her more expansive understanding of the term ‘Oriental’ to include the Far East and her conce...

Impact of Disease Prevalence Adjustment on Hospitalization Rates for Chronic Ambulatory Care-Sensitive Conditions in Germany.

Science.gov (United States)

Pollmanns, Johannes; Romano, Patrick S; Weyermann, Maria; Geraedts, Max; Drösler, Saskia E

2018-04-01

To explore effects of disease prevalence adjustment on ambulatory care-sensitive hospitalization (ACSH) rates used for quality comparisons. County-level hospital administrative data on adults discharged from German hospitals in 2011 and prevalence estimates based on administrative ambulatory diagnosis data were used. A retrospective cross-sectional study using in- and outpatient secondary data was performed. Hospitalization data for hypertension, diabetes, heart failure, chronic obstructive pulmonary disease, and asthma were obtained from the German Diagnosis Related Groups (DRG) database. Prevalence estimates were obtained from the German Central Research Institute of Ambulatory Health Care. Crude hospitalization rates varied substantially across counties (coefficients of variation [CV] 28-37 percent across conditions); this variation was reduced by prevalence adjustment (CV 21-28 percent). Prevalence explained 40-50 percent of the observed variation (r = 0.65-0.70) in ACSH rates for all conditions except asthma (r = 0.07). Between 30 percent and 38 percent of areas moved into or outside condition-specific control limits with prevalence adjustment. Unadjusted ACSH rates should be used with caution for high-stakes public reporting as differences in prevalence may have a marked impact. Prevalence adjustment should be considered in models analyzing ACSH. © Health Research and Educational Trust.

[Service productivity in hospital nursing--conceptual framework of a productivity analysis].

Science.gov (United States)

Thomas, D; Borchert, M; Brockhaus, N; Jäschke, L; Schmitz, G; Wasem, J

2015-01-01

Decreasing staff numbers compounded by an increasing number of cases is regarded as main challenge in German hospital nursing. These input reductions accompanied by output extensions imply that hospital nursing services have had to achieve a continuous productivity growth in the recent years. Appropriately targeted productivity enhancements require approved and effective methods for productivity acquisition and measurement. However, there is a lack of suitable productivity measurement instruments for hospital nursing services. This deficit is addressed in the present study by the development of an integrated productivity model for hospital nursing services. Conceptually, qualitative as well as quantitative aspects of nursing services productivity are equally taken into consideration. Based on systematic literature reviews different conceptual frameworks of service productivity and the current state of research in hospital nursing services productivity were analysed. On this basis nursing sensitive inputs, processes and outputs were identified and integrated into a productivity model. As an adequate framework for a hospital nursing services productivity model the conceptual approach by Grönroos/Ojasalo was identified. The basic structure of this model was adapted stepwise to our study purpose by integrating theoretical and empirical findings from the research fields of service productivity, nursing productivity as well as national and international nursing research. Special challenges existed concerning the identification of relevant influencing factors as well as the representation of nursing sensitive outputs. The final result is an integrated productivity model, which can be used as an adequate framework for further research in hospital nursing productivity. Research on hospital nursing services productivity is rare, especially in Germany. The conceptual framework developed in this study builds on established knowledge in service productivity research. The

'Good Hunting': German submarine offensives and South African ...

African Journals Online (AJOL)

By the latter half of 1942, the High Command of the German U-boats (BdU) realised that the 'sinking results' of the North Atlantic had decreased immensely. The successes of the Allied anti-submarine operations in the North Atlantic precluded the successful employment of the German submarines in said waters.

Crystal chemistry of germanates: Characteristic structural features of Li,Ge-germanates

International Nuclear Information System (INIS)

Ilyushin, G.D.; Dem'yanets, L.N.

2000-01-01

Crystallochemical classification of eleven compounds from the Li-germanate family is suggested. Depending on the set of the primary building units (PBU) (M-octahedra of the composition [GeO 6 ] and T-tetrahedra of the composition [GeO 4 ]) and the type of their 'condensation', these germanates are divided into three crystallochemical groups: framework MT-structures (four phases), condensed MT-structures (two phases), and tetrahedral T-condensed structures (five phases). The structural characteristics of the framework Li,Ge-germanates are considered, i.e., their symmetry, crystallographically independent sets of the primary building units, framework architecture, and the types of chains and layers of the (Ge,O)-radicals

Job satisfaction among hospital doctors in Norway and Germany. A comparative study on national samples.

Science.gov (United States)

Rosta, Judith; Nylenna, Magne; Aasland, Olaf G

2009-07-01

To compare German and Norwegian hospital doctors on 10 different aspects of job satisfaction and general life satisfaction. The study population consisted of a representative sample of 1,448 German and 484 Norwegian hospital doctors aged 33-65 years (n = 1,932), selected from nationwide postal surveys in 2006. The questionnaires contained items on subjective life satisfaction and the validated 10-item Job Satisfaction Scale. Each item was scored on a seven-point Likert scale from 1 (very dissatisfied) to 7 (very satisfied). A mean sum score was calculated, ranging from 1 to 7. Regression analyses and generalized-linear-model-estimated means controlled for age and gender with 95% confidence intervals were used for comparison. Norwegian hospital doctors had significantly higher life satisfaction (mean 5.31 vs. 5.15) and job satisfaction (mean 5.09 vs. 4.55) than their German colleagues. Item by item, doctors in Norway were significantly more content with seven aspects of their work: "Freedom to choose your own methods of working'' (mean 5.00 vs. 4.72), "opportunities to use your skills'' (mean 5.49 vs. 5.01), "physical working conditions'' (mean 4.62 vs. 4.08), "recognition you get for good achievements'' (mean 4.83 vs. 4.26), "overall job situation'' (mean 5.57 vs. 4.64), "work hours'' (mean 4.39 vs. 3.39), "ate of pay'' (mean 4.70 vs. 3.70). General life satisfaction and age, but not gender, were positively associated with job satisfaction in both countries. Norwegian hospital doctors enjoy a higher level of life and job satisfaction than German hospital doctors. The most likely reasons for this are more acceptable work hours, salary and control over clinical work in Norway.

Extraction of UMLS® Concepts Using Apache cTAKES™ for German Language.

Science.gov (United States)

Becker, Matthias; Böckmann, Britta

2016-01-01

Automatic information extraction of medical concepts and classification with semantic standards from medical reports is useful for standardization and for clinical research. This paper presents an approach for an UMLS concept extraction with a customized natural language processing pipeline for German clinical notes using Apache cTAKES. The objectives are, to test the natural language processing tool for German language if it is suitable to identify UMLS concepts and map these with SNOMED-CT. The German UMLS database and German OpenNLP models extended the natural language processing pipeline, so the pipeline can normalize to domain ontologies such as SNOMED-CT using the German concepts. For testing, the ShARe/CLEF eHealth 2013 training dataset translated into German was used. The implemented algorithms are tested with a set of 199 German reports, obtaining a result of average 0.36 F1 measure without German stemming, pre- and post-processing of the reports.

Music to Teach German By.

Science.gov (United States)

Schulte, Leo

1985-01-01

Discusses how music can be intergrated with regular lesson plans to teach German vocabulary, grammar, and history and to give insights into German culture. Also included are sources for basic background information, a list of recordings of the German music, and notes on selecting and presenting it in the language class. (SED)

Hospital innovation portfolios: Key determinants of size and innovativeness

DEFF Research Database (Denmark)

Schultz, Carsten; Zippel-Schultz, Bettina; Salomo, Søren

2012-01-01

and reward systems) organizational mechanisms. Methodology: To develop hypotheses, we integrated the innovation management literature into the hospital context. Detailed information about the innovation portfolio of 87 German hospitals was generated and combined with multirespondent survey data using ratings....... Reward systems did not have direct effects on the composition of innovation portfolios. However, they adjusted bottom-up employee and top-down strategic initiatives to match with the existing organization, thereby decreasing the degree of innovativeness and enforcing exploitation. Practice Implications......: Hospitals should intertwine employee encouragement, analytical approaches, and formal reward systems depending on organizational goals....

Curriculum design and German student exchange for Sino-German Bachelor program majored in optoelectronics engineering

Science.gov (United States)

Zheng, Jihong; Fuhrmann, Thomas; Xu, Boqing; Schreiner, Rupert; Jia, Hongzhi; Zhang, Wei; Wang, Ning; Seebauer, Gudrun; Zhu, Jiyan

2017-08-01

Different higher education backgrounds in China and Germany led to challenges in the curriculum design at the beginning of our cooperative bachelor program in Optoelectronics Engineering. We see challenges in different subject requirements from both sides and in the German language requirements for Chinese students. The curriculum was optimized according to the ASIIN criteria, which makes it acceptable and understandable by both countries. German students are integrated into the Chinese class and get the same lectures like their Chinese colleagues. Intercultural and curriculum challenges are successfully solved. The results are summarized to provide an example for other similar international programs.

[The hospital at Hillersleben Germany, April 1945].

Science.gov (United States)

Weisskopf, Varda

2014-01-01

On 6th April 1945, nine days before the liberation of the Bergen Belsen Concentration Camp, about 2,500 Jewish prisoners were ordered to prepare to leave the camp on the next day. On 7th April, the prisoners left through the gates of the camp and began to walk about 10 kilometers to the train station near the city of Celle. There they were ordered to board a train that would take them to the Theresienstadt Concentration Camp. After six days of travel, the train stopped near the village of Farsleben, Germany, where it was liberated by the 743rd Tank Battalion of the 30th Infantry Division, of the U.S. 9th Army, on 13th April 1945. The 105th Medical Battalion of the same Division was the primary care provider for the survivors, who were then taken in vehicles available from the 30th Infantry Division, and organized into a convoy by the Division's Liaison Officer, Lt. Frank W. Towers, to the town of Hillersleben. A former German Air Force Base was located at Hillersleben with a small hospital that could not provide medical attention to all the survivors. On 21st April, Company C of the 95th Medical Battalion, received an order to go to Hillersleben. Colonel Dr. William W. Hurteau, the Commanding Officer of this Battalion, determined that the biggest task given to the Battalion during World War II, was establishing another hospital in the town of Hillersleben and providing additional beds in the existing hospital, which was a structure that had served as a boarding school. Furthermore, they needed to acquire hospital equipment which was obtained from German equipment and supplies that had been captured by the U.S. MiLitary. Also, they took care of obtaining food supplies from German warehouses, and meat and milk from local dairy farms. The lives of the prisoners on this train were saved by the heroism and dedicated work of those brave soldiers of the 30th Infantry Division and the 95th Medical Battalion.

The reliability of the German version of the Richards Campbell Sleep Questionnaire.

Science.gov (United States)

Krotsetis, Susanne; Richards, Kathy C; Behncke, Anja; Köpke, Sascha

2017-07-01

The assessment of sleep quality in critically ill patients is a relevant factor of high-quality care. Despite the fact that sleep disturbances and insufficient sleep management contain an increased risk of severe morbidity for these patients, a translated and applicable instrument to evaluate sleep is not available for German-speaking intensive care settings. This study aimed to translate the Richards Campbell Sleep Questionnaire (RCSQ), a simple and validated instrument eligible for measuring sleep quality in critically ill patients, and subsequently to evaluate the internal consistency of the German version of the RCSQ. Furthermore, it also aimed to inquire into the perception of sleep in a sample of critically ill patients. The RCSQ was translated following established methodological standards. Data were collected cross-sectionally in a sample of 51 patients at 3 intensive care units at a university hospital in Germany. The German version of the RCSQ showed an overall internal consistency (Cronbach's alpha) of 0·88. The mean of the RSCQ in the sample was 47·00 (SD ± 27·57). Depth of sleep was rated the lowest and falling asleep again the highest of the RCSQ sleep items. The study demonstrated very good internal consistency of the German version of the RCSQ, allowing for its application in practice and research in German-speaking countries. Quality of sleep perception was generally low in this sample, emphasizing the need for enhanced care concepts regarding the sleep management of critically ill patients. Relevance to clinical practice Assessment of self-perception of sleep is crucial in order to plan an individually tailored care process. © 2017 British Association of Critical Care Nurses.

Vestibular morphology in the German Waltzing guinea pig.

Science.gov (United States)

Kawaguchi, Sachie; Hultcrantz, Malou; Jin, Zhe; Ulfendahl, Mats; Suzuki, Mamoru

2010-04-01

The German waltzing guinea pig is a special strain of animal with a recessively inherited inner ear defect, resulting in deafness and a severe vestibular dysfunction. The hearing loss in the cochlea of the German strain is a result of a collapse of the Reissner membrane and the absence of scala media. The vestibular organ has not yet been described. German waltzing guinea pigs (homozygote and heterozygote) of different ages ranging from embryologic age 25 days to adulthood were investigated. The living animals were tested with four different vestibular tests, and the fetuses were controlled according to breeding. The morphology of the vestibular parts (ampulla, saccule, and utricle) was observed by using the light and transmission electron microscopy. Collapse of the membranous labyrinth was found already at embryologic age 50 days and progressed over time. Vestibular dysfunction was noted already from birth. Vestibular atelectasis has been shown to have the same morphology as the reported vestibular dysfunction in the German waltzing guinea pig. Owing to this similarity, this animal can be a good model for vestibular research.

Genesis and Evolution of the Romance-Germanic Language Border in Europe.

Science.gov (United States)

van Durme, Luc

2002-01-01

Discusses various language border theories for the Belgian-Northern French area, and summarizes the results of 40 years of research into the development of the Romance-Germanic language border at large. Suggests that a late Roman Latin-Germanic opposition has functioned as a direct predisposition for the early medieval Romance-Germanic language…

Acquisition of German pluralization rules in monolingual and multilingual children

Directory of Open Access Journals (Sweden)

Eugen Zaretsky

2013-10-01

Full Text Available Existing studies on plural acquisition in German have relied on small samples and thus hardly deliver generalizable and differentiated results. Here, overgeneralizations of certain plural allomorphs and other tendencies in the acquisition of German plural markers are described on the basis of test data from 7,394 3- to 5-yearold monolingual German and bi/multilingual immigrant children tested with a modified, validated version of the Marburger Sprachscreening (MSS language test and 476 children tested with the SETK 3-5 language test. Classified correct and wrong answers to MSS and SETK 3-5 plural items were compared. The acquisition patterns of immigrants corresponded to those of younger German children. Both monolingual German and immigrant children demonstrated generally the same universal frequency and phonetically/phonologically based error patterns, irrespective of their linguistic background, but with different tendencies such as overgeneralization of -s by German children only.

[The role of university hospital executive board members].

Science.gov (United States)

Debatin, J F; Rehr, J

2009-09-01

Demographic changes and medical progress in combination with vastly altered regulatory and economic environments have forced considerable change in the structure of German university hospitals in recent years. These changes have affected medical care as well as research and medical school training. To allow for more flexibility and a higher level of reactivity to the changing environment German university hospitals were transferred from state agencies to independent corporate structures. All but one remains wholly owned by the respective state governments. The governing structure of these independent medical hospitals consists of an executive board, generally made up of a medical director, a financial director, a director for nursing, and the dean of the medical faculty. In most hospitals, the medical director serves as chief executive officer. The regulations governing the composition and responsibility of the members of the executive board differ from state to state. These differences do affect to some degree the interactive effectiveness of the members of the executive boards. Modalities that stress the overall responsibility for all board members seem to work better than those that define clear portfolio limits. Even more than organizational and regulatory differences, the effectiveness of the work of the executive boards is influenced by the personality of the board members themselves. Success appears to be a clear function of the willingness of all members to work together.

The German risk study. Pt. 2

International Nuclear Information System (INIS)

Burkart, K.

1980-01-01

A severe nuclear power plant accident can be followed by a considerable release of radioactive effluents into the atmosphere. Due to atmospheric dispersion, areas of different sizes can be contaminated. The corresponding doses can cause early illnesses, early fatalities, latent effects and genetic effects. They are accompanied by economic effects. Within the consequence model of the German Risk Study, early and late fatalities and genetically significant doses are calculated. The calculations are based on real data or phenomena such as the population around 19, present or future German sites, or 115 real weather sequences, as well as on models such as an atmospheric dispersion model, a dose model, a model of protective actions or a health effects model. Within this lecture, the consequence model applied in the German Risk Study will be discussed in detail and the results will be presented. (orig./RW)

Validation of the German version of the insomnia severity index in adolescents, young adults and adult workers: results from three cross-sectional studies.

Science.gov (United States)

Gerber, Markus; Lang, Christin; Lemola, Sakari; Colledge, Flora; Kalak, Nadeem; Holsboer-Trachsler, Edith; Pühse, Uwe; Brand, Serge

2016-05-31

A variety of objective and subjective methods exist to assess insomnia. The Insomnia Severity Index (ISI) was developed to provide a brief self-report instrument useful to assess people's perception of sleep complaints. The ISI was developed in English, and has been translated into several languages including German. Surprisingly, the psychometric properties of the German version have not been evaluated, although the ISI is often used with German-speaking populations. The psychometric properties of the ISI are tested in three independent samples: 1475 adolescents, 862 university students, and 533 police and emergency response service officers. In all three studies, participants provide information about insomnia (ISI), sleep quality (Pittsburgh Sleep Quality Index), and psychological functioning (diverse instruments). Descriptive statistics, gender differences, homogeneity and internal consistency, convergent validity, and factorial validity (including measurement invariance across genders) are examined in each sample. The findings show that the German version of the ISI has generally acceptable psychometric properties and sufficient concurrent validity. Confirmatory factor analyses show that a 1-factor solution achieves good model fit. Furthermore, measurement invariance across gender is supported in all three samples. While the ISI has been widely used in German-speaking countries, this study is the first to provide empirical evidence that the German version of this instrument has good psychometric properties and satisfactory convergent and factorial validity across various age groups and both men and women. Thus, the German version of the ISI can be recommended as a brief screening measure in German-speaking populations.

Highly specific reasons for nonadherence to antiretroviral therapy: results from the German adherence study

Directory of Open Access Journals (Sweden)

Boretzki J

2017-11-01

Full Text Available Johanna Boretzki,1,2 Eva Wolf,3 Carmen Wiese,4 Sebastian Noe,4 Annamaria Balogh,3 Anja Meurer,5 Ivanka Krznaric,6 Alexander Zink,7 Christian Lersch,1 Christoph D Spinner1,2 1Department of Medicine II, University Hospital Klinikum rechts der Isar, Munich, 2German Center for Infection Research, Partner Site Munich, 3MUC Research, Munich, 4MVZ Karlsplatz, HIV Clinical Care Center, Munich, 5Center for Infectiology and Internal Medicine, Munich, 6Center for Infectiology Prenzlauer Berg, Berlin, 7Department of Dermatology and Allergology, University Hospital Klinikum rechts der Isar, Munich, Germany Background: Reasons for and frequency of nonadherence to antiretroviral therapy (ART may have changed due to pharmacological improvements. In addition, the importance of known non-pharmacologic reasons for nonadherence is unclear.Methods: We performed a cross-sectional, noninterventional, multicenter study to identify current reasons for nonadherence. Patients were categorized by physicians into the following adherence groups: good, unstable, or poor adherence. Co-variables of interest included age, sex, time since HIV diagnosis, ART duration, current ART regimen, HIV transmission route, comorbidity, HIV-1 RNA viral load (VL, and CD4 cell count. Patients self-reported the number of missed doses and provided their specific reasons for nonadherent behavior. Statistical analyses were performed using Fisher’s extended exact test, Kruskal–Wallis test, and logistic regression models.Results: Our study assessed 215 participants with good (n=162, unstable (n=36, and poor adherence (n=17. Compared to patients with good adherence, patients with unstable and poor adherence reported more often to have missed at least one dose during the last week (good 11% vs unstable 47% vs poor 63%, p<0.001. Physicians’ adherence assessment was concordant with patients’ self-reports of missed doses during the last week (no vs one or more in 81% cases. Similarly, we found a

Neutron monitor measurements on the German research vessel Polarstern. First results

Energy Technology Data Exchange (ETDEWEB)

Heber, B. [Insititut fuer Experimentelle und Angewandte Physik, Christian-Albrechts-Universitaet zu Kiel (Germany); Schwerdt, C.; Walter, M. [Deutsches Elektronen-Synchrotron DESY, D-15738 Zeuthen (Germany); Bernade, G.; Fuchs, R.; Krueger, H.; Moraal, H. [Center for Space Research, North-West University, Potchefstroom 2520 (South Africa)

2014-07-01

Cosmic-ray particles provide a unique opportunity to probe the dynamic conditions in the highly variable heliosphere. The longest continuous measurements of galactic cosmic rays come from cosmogenic isotopes and from neutron monitors located at different location on Earth. Understanding the effects of energetic particles in and on the atmosphere and the environment of Earth must address their transport to Earth and their interactions with the Earth's atmosphere, including their filtering by the terrestrial magnetosphere. Since neutron monitors are integral detectors of secondary cosmic rays produced in the atmosphere, a single neutron monitor can only derive the energy spectra of the particles impinging on the Earth during latitudinal surveys. A portable neutron monitor was built at the North-West University, South Africa, and was installed on the German research vessel Polarstern. Such latitude surveys have been done before, but this vessel is better suited for this purpose than previous platforms because it traverses all the locations with geomagnetic cutoff rigidities from <<1 GV to 15 GV at least twice per year. In this contribution we present first results from the measurement campaigns.

[The Rockefeller Foundation and its efforts toward a reorientation of German medicine and public health in the 1950s].

Science.gov (United States)

Schleiermacher, Sabine

2010-01-01

The Rockefeller Foundation invested substantial funds into promoting the development of public health as a discipline and a re-orientation of medical training in West Germany to support the democratization of German society. Not limiting itself to the simple provision of literature, the Foundation pursued a two-pronged strategy. Firstly, the Foundation organized a program for German university physicians and public health officers to visit various universities and teaching hospitals in the USA and Canada. A second aim was to establish training institutes for postgraduate physicians. However, rather than simply imposing the US model, the Foundation intended to adapt it to the German context, in the form of a postgraduate course for physicians that integrated practical experience with a university setting. My research to date shows that the Foundation's activities did not meet with much enthusiasm from German medical professionals. Intellectual, cultural, cognitive and political differences impaired constructive collaboration between the Foundation's staff and local practitioners and academics.

[Prevalence of malnutrition, interventions and quality indicators in German nursing homes - first results of a nationwide pilot study].

Science.gov (United States)

Bartholomeyczik, S; Reuther, S; Luft, L; van Nie, N; Meijers, J; Schols, J; Halfens, R

2010-12-01

The aims of this study were to test the transfer and feasibility of a Dutch annual survey on malnutrition into German nursing homes and to gather first data about the prevalence of malnutrition, treatment and quality indicators in German resident homes. A cross-sectional multicentre study, using a standardised multilevel instrument (observation, questionnaire) developed in the University of Maastricht was applied. Variables are indicators for malnutrition and its risks, quality indicators, care dependency and treatment initiatives. The sample consisted of 32 nursing homes with 2,444 participating residents. 26% of the residents show indicators of malnutrition, a risk of malnutrition can be found in another 28%. Only one quarter of the nursing homes use a standardised nutritional screening instrument. Significantly more people with dementia have indicators of malnutrition. Most facilities provide a protocol or a guideline for the prevention and treatment of malnutrition. Also most are training their staff regularly in questions of malnutrition, half the institutions employ dieticians or nutritionists. Special treatment was initiated in half of all residents having indicators of malnutrition or showing a risk. The Dutch instrument is applicable in German nursing homes. Its utilisation shows that malnutrition is still a problem in German nursing homes. The standardised assessment of nutritional status is the exception; the interventions carried out should be improved.

[Work and Training Conditions of Young German Physicians in Internal Medicine - Results of a Second Nationwide Survey by Young Internists from the German Society of Internal Medicine and the German Professional Association of Internists.

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Raspe, Matthias; Vogelgesang, Anja; Fendel, Johannes; Weiß, Cornelius; Schulte, Kevin; Rolling, Thierry

2018-04-01

 Medical specialty training is the basis for career development of young internists and it is vital for the delivery of high-quality medical care. In 2014 the young internists of two professional bodies in Germany conducted a survey among their young members and described major factors influencing training and working conditions. We present the results of a follow-up survey to describe changes of these factors over time. An additional focus is set on the difficulties of balancing medical career and family.  In the end of 2016 we conducted an online-based survey of all members in training of the German Society of Internal Medicine (DGIM) and the Professional Association of German Internists (BDI). The questionnaire used in the 2014 survey was modified and items investigating the balance between career and family were added.  A total of 1587 questionnaires were returned and analysed. Mayor findings did not change over time. Psychosocial strain remains very high among medical trainees in internal medicine. A structured training curriculum and meaningful feedback are associated with lower psychosocial strain and higher work satisfaction. Internists - and here especially women - with children experience the daily balance of medical career and family as extremely challenging.  These results demonstrate that there is still a serious need for adjusting training and working conditions of young internists in Germany. Especially the role and increasing importance of female physicians has to be recognized by enabling a successful integration of medical career and family. © Georg Thieme Verlag KG Stuttgart · New York.

TOWARDS A GERMAN LANGUAGE FRAMEWORK FOR MALAYSIABASED MULTINATIONAL COMPANIES (MNCS

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Siti Waltraud Brigitte Mayr

2016-08-01

Full Text Available Purpose - The aim of this study is to introduce an approach to managing business communication based on the German language needs of employees in multinational companies in Malaysia and the expectations of employers in the teaching of German in their companies. As additional variables, training for sustainable development (ESD and for maximizing the mutual understanding in personal interactions is included. Design / methodology / approach – This paper is reflecting on the spectrum of ideas about the teaching of German in German companies in Malaysia that was obtained through the author’s earlier target situation analysis in MNCs in Malaysia. In addition to a variety of methods that is incorporated to engage students in the learning process, a ‘meaning negotiation’ approach is applied in order to deal with the intercultural communication practices. Results - The paper outlines a set of topics and strategies that can assist employees in intercultural interaction contexts in a German Malaysia-based company. It draws them together into a conceptual framework of required skills in a German beginner class. Originality / Benefits - This study contributes to the current issues concerning the German mediation requirements in the management field.

Data from the German Chest Pain Unit Registry: The well known gap between knowledge and practice.

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Fernández-Bergés, Daniel

2017-11-01

In-hospital mortality of acute myocardial infarction with ST segment elevation remains high and is influenced by many factors, some of which are modifiable such as time to treatment initiation and modality of treatment. It is well established that reperfusion therapy is the gold-standard in the management of ST-elevation acute myocardial infarction. Despite recent developments and clear, comprehensible guidelines recommendations, it remains difficult to disseminate this knowledge to medical practitioners. The German Chest Pain Unit shows that the best door-to-balloon time is reached when patients contact the Emergency Medical Systems (EMS) directly, rather than when referred by the general practitioner (GP), or are transferred from another hospital, or present as a self-referral. In order to improve mortality in ST-elevation acute myocardial infarction, patients must be able to recognize symptoms and call the EMS as soon as possible, in addition to having an ECG within ten minutes and direct access to reperfusion therapy (PPCI preferred). The German Registry has highlighted the importance of training both patients and doctors. Copyright © 2017 Elsevier B.V. All rights reserved.

[Hospital financing in 2016. Relevant changes for rheumatology].

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Fiori, W; Bunzemeier, H; Lakomek, H-J; Buscham, K; Lehmann, H; Fuchs, A-K; Bessler, F; Roeder, N

2016-03-01

Hospital financing 2016 will be influenced by the prospects of the approaching considerable changes. It is assumed that the following years will lead to a considerable reallocation of financial resources between hospitals. While not directly targeted by new regulations, reallocations always also affect specialties like rheumatology. Compared to the alterations in the legislative framework the financial effects of the yearly adaptation of the German diagnosis-related groups system are subordinate. Only by comprehensive consideration of current and expected changes a forward-looking and sustainable strategy can be developed. The following article presents the relevant changes and discusses the consequences for hospitals specialized in rheumatology.

The founding of Zemun Hospital

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Milanović Jasmina

2014-01-01

Full Text Available This year Zemun Hospital - Clinical Hospital Center Zemun celebrates 230th anniversary of continuous work, thus becoming the oldest medical facility in Serbia. The exact date of the hospital founding has been often questioned in history. Various dates appeared in the literature, but the most frequent one was 25th of February 1784. Until now, the document which confirms this has never been published. This article represents the first official publication of the document which confirms that Zemun Hospital was indeed founded on this date. The first hospitals started emerging in Zemun when the town became a part of the Habsburg Monarchy. The first sanitary facility ever formed was the “Kontumac” - a quarantine established in 1730. Soon after, two more confessional hospitals were opened. The Serbian (Orthodox Hospital was founded before 1769, whereas the German (Catholic Hospital started working in 1758. Both hospitals were financed, amongst others, by the Town Hall - the Magistrate. In order to improve efficiency of these hospitals, a decision was made to merge them into a single City Hospital. It was founded on 25th February 1784, when the General Command ordered the Magistrate of Zemun to merge the financess of all existing hospitals and initiate the construction of a new building. Although financially united, the hospitals continued working in separate buildings over a certain period of time. The final, physical merging of these hospitals was completed in 1795. [Projekat Ministarstva nauke Republike Srbije, br. 47030

German and Korean mothers' sensitivity and related parenting beliefs

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Ziehm, Jeanette; Trommsdorff, Gisela; Heikamp, Tobias; Park, Seong-Yeon

2013-01-01

This study contributes to a differentiated understanding of maternal sensitivity in cultural and situational context. We investigated differences and similarities in German and Korean mothers' maternal sensitivity. We interviewed 92 German and 100 Korean mothers of first graders about their preference for proactive (anticipating children's needs) or reactive sensitivity (responding to children's direct cues) in different scenarios. Related parenting beliefs were assessed by asking the mothers to explain the reasons why they would prefer specific parenting behaviors. Results revealed significant cultural differences in reactive vs. proactive sensitivity preferences. Overall, German mothers were more likely to indicate that a mother should respond reactively and less likely to report that a mother should act proactively than were Korean mothers. Korean mothers gave preference to both reactive and proactive sensitivity depending on the scenario. With regard to parenting beliefs, analyses revealed that German and Korean mothers who preferred reactive sensitivity mainly explained their choices as attempts to encourage children's development of independence. In contrast, Korean and German mothers with a preference for proactive sensitivity were more likely to report that mothers would assist their children due to their immaturity in dealing with emotional distress. Results are discussed in the framework of the different meanings and functions of maternal sensitivity for socialization in different cultural contexts. PMID:23986740

Layers of root nouns in Germanic

DEFF Research Database (Denmark)

Hansen, Bjarne Simmelkjær Sandgaard

2017-01-01

The root-noun declension became productive in early Germanic, containing (I) inherited root nouns, (IIa) original substrate or loan words, and transitions from other declensions in (IIb) Proto-Germanic and (III) North Germanic. As ablaut was abolished, the inherited type would display ablaut grades...

Why all John’s friends are Dutch, not German; on differences in West Germanic in the interaction between universal quantifiers and genitives

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Robert Cirillo

2014-11-01

Full Text Available Unlike English and Dutch, German does not allow a genitive to follow a universal quantifier: (i All John’s friends… (ii Al Jans vrienden… (Dutch (iii *All(e Johanns Freunde… (German In this article I show that this discrepancy results from two facts. Firstly, the German Saxon Genitive is a true case ending assigned in [Spec, NP] or [Spec, PossP] while in Dutch and English genitive case cannot be assigned at the N or n level (without a preposition and the Saxon Genitive is more like a possessive adjective, initiating as the head of PossP and terminating in D. Secondly, in Germanic, D or [Spec, DP] must be overtly occupied in case of definiteness, and if the D node is already overtly occupied, and if genitive case has already been assigned, there is no motivation for moving a genitive phrase to the D level. I also show that Germanic dative of possession constructions (possessor doubling can be explained within the same framework. Finally, there is a brief discussion of the potential applicability of this analysis to Scandinavian.

Regional variation in hospital admission rates in the Netherlands, Belgium, Northern France and Nordrhein-Westfalen.

NARCIS (Netherlands)

Noordt, M. van; Zee, J. van der; Groenewegen, P.P.

1992-01-01

For the analysis of regional variations in hospital admission rates a model was set up, including both supply and demand indicators. Data were gathered for regions in four health care systems (the Dutch, Belgian, French and German), for 1982, 1979, 1974 (France 1982 only). Hospital bed supply proved

German neutron scattering conference. Programme and abstracts

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Brueckel, Thomas (ed.)

2012-07-01

The German Neutron Scattering Conference 2012 - Deutsche Neutronenstreutagung DN 2012 offers a forum for the presentation and critical discussion of recent results obtained with neutron scattering and complementary techniques. The meeting is organized on behalf of the German Committee for Research with Neutrons - Komitee Forschung mit Neutronen KFN - by the Juelich Centre for Neutron Science JCNS of Forschungszentrum Juelich GmbH. In between the large European and international neutron scattering conferences ECNS (2011 in Prague) and ICNS (2013 in Edinburgh), it offers the vibrant German and international neutron community an opportunity to debate topical issues in a stimulating atmosphere. Originating from ''BMBF Verbundtreffen'' - meetings for projects funded by the German Federal Ministry of Education and Research - this conference series has a strong tradition of providing a forum for the discussion of collaborative research projects and future developments in the field of research with neutrons in general. Neutron scattering, by its very nature, is used as a powerful probe in many different disciplines and areas, from particle and condensed matter physics through to chemistry, biology, materials sciences, engineering sciences, right up to geology and cultural heritage; the German Neutron Scattering Conference thus provides a unique chance for exploring interdisciplinary research opportunities. It also serves as a showcase for recent method and instrument developments and to inform users of new advances at neutron facilities.

German neutron scattering conference. Programme and abstracts

International Nuclear Information System (INIS)

Brueckel, Thomas

2012-01-01

The German Neutron Scattering Conference 2012 - Deutsche Neutronenstreutagung DN 2012 offers a forum for the presentation and critical discussion of recent results obtained with neutron scattering and complementary techniques. The meeting is organized on behalf of the German Committee for Research with Neutrons - Komitee Forschung mit Neutronen KFN - by the Juelich Centre for Neutron Science JCNS of Forschungszentrum Juelich GmbH. In between the large European and international neutron scattering conferences ECNS (2011 in Prague) and ICNS (2013 in Edinburgh), it offers the vibrant German and international neutron community an opportunity to debate topical issues in a stimulating atmosphere. Originating from ''BMBF Verbundtreffen'' - meetings for projects funded by the German Federal Ministry of Education and Research - this conference series has a strong tradition of providing a forum for the discussion of collaborative research projects and future developments in the field of research with neutrons in general. Neutron scattering, by its very nature, is used as a powerful probe in many different disciplines and areas, from particle and condensed matter physics through to chemistry, biology, materials sciences, engineering sciences, right up to geology and cultural heritage; the German Neutron Scattering Conference thus provides a unique chance for exploring interdisciplinary research opportunities. It also serves as a showcase for recent method and instrument developments and to inform users of new advances at neutron facilities.

The French-German initiative for Chernobyl: Overview of the French-German initiative

Energy Technology Data Exchange (ETDEWEB)

Biesold, H.; Friederichs, H.G.; Pretzsch, G. [Gesellschaft fuer Anlagen- und Reaktorsicherheit mbH (GRS), Dept. International Programmes, Berlin (Germany); Deville-Cavelin, G.; Lhomme, V.; Rutschkowsky, N.; Tirmarche, M. [Institut de Radioprotection et de Surete Nucleaire (IRSN), Dept. International Relations, 92 - Clamart (France); Bazyka, D.; Chabanyuk, V.; Seleznev, A. [Chornobyl Center (CC), Kiev regoin (Ukraine); Kellerer, A.M. [Munchen Univ., Strahlenbiologisches Institut (Germany)

2006-07-01

- Purpose: The main purpose of the French-German Initiative is to assist in the collection and validation of the existing data in Ukraine, Belarus and Russia for developing a reliable and objective basis useful for the planning of counter-measures, for information of the public, and for future work. - Coordination: GRS (Gesellschaft fuer Anlagen- und Reaktorsicherheit), supported in programme 3 by SBI (Strahlenbiologisches Institut der Universitaet Muenchen) and IRSN (Institut de radioprotection et de surete nucleaire) are coordinating the projects on the Western side. The CC (Chernobyl Center for Nuclear Safety, Radioactive Waste and Radioecology) as Eastern coordinator is also the beneficiary. German Support by Bundesministerium fuer Umwelt, Naturschutz und Reaktorsicherheit (BMU), Vereinigung Deutscher Elektrizitaetswerke (VDEW) e.V.; French Support by Institut de radioprotection et de surete nucleaire (IRSN), Electricite de France (EdF). - Programmes: Three scientific and technical co-operation programmes are financed with a total budget of about 6 million Euro within the frame work of the French- German Initiative: Programme 1: SARCOPHAGUS: Safety of the Chernobyl 'Sarcophagus', Programme 2: RADIOECOLOGY: Study of the radioecological consequences of the accident,Programme 3: HEALTH: Study of health effects. - Background: At the IAEA conference in Vienna in April 1996 - 10 years after the Chernobyl accident - the French and German Environment Ministers jointly announced their co-operation initiative with the Ukraine, Belarus and Russia over scientific programmes concerning the aftermath of the Chernobyl disaster. Numerous scientific studies have been conducted in the affected republics of the former USSR with and without the participation of international organisations, but largely with insufficient real co-ordination. For some of the studies, results have never been publicly documented. There are still incoherent or even contradictory reports on the

Assessing and comparing information security in swiss hospitals.

Science.gov (United States)

Landolt, Sarah; Hirschel, Jürg; Schlienger, Thomas; Businger, Walter; Zbinden, Alex M

2012-11-07

Availability of information in hospitals is an important prerequisite for good service. Significant resources have been invested to improve the availability of information, but it is also vital that the security of this information can be guaranteed. The goal of this study was to assess information security in hospitals through a questionnaire based on the International Organization for Standardization (ISO) and the International Electrotechnical Commission (IEC) standard ISO/IEC 27002, evaluating Information technology - Security techniques - Code of practice for information-security management, with a special focus on the effect of the hospitals' size and type. The survey, set up as a cross-sectional study, was conducted in January 2011. The chief information officers (CIOs) of 112 hospitals in German-speaking Switzerland were invited to participate. The online questionnaire was designed to be fast and easy to complete to maximize participation. To group the analyzed controls of the ISO/IEC standard 27002 in a meaningful way, a factor analysis was performed. A linear score from 0 (not implemented) to 3 (fully implemented) was introduced. The scores of the hospitals were then analyzed for significant differences in any of the factors with respect to size and type of hospital. The participating hospitals were offered a benchmark report about their status. The 51 participating hospitals had an average score of 51.1% (range 30.6% - 81.9%) out of a possible 100% where all items in the questionnaire were fully implemented. Room for improvement could be identified, especially for the factors covering "process and quality management" (average score 1.3 ± 0.8 out of a maximum of 3) and "organization and risk management" (average score 1.3 ± 0.7 out of a maximum of 3). Private hospitals scored significantly higher than university hospitals in the implementation of "security zones" and "backup" (P = .008). Half (50.00%, 8588/17,177) of all assessed hospital beds

Abridged version of the AWMF guideline for the medical clinical diagnostics of indoor mould exposure: S2K Guideline of the German Society of Hygiene, Environmental Medicine and Preventive Medicine (GHUP) in collaboration with the German Association of Allergists (AeDA), the German Society of Dermatology (DDG), the German Society for Allergology and Clinical Immunology (DGAKI), the German Society for Occupational and Environmental Medicine (DGAUM), the German Society for Hospital Hygiene (DGKH), the German Society for Pneumology and Respiratory Medicine (DGP), the German Mycological Society (DMykG), the Society for Pediatric Allergology and Environmental Medicine (GPA), the German Federal Association of Pediatric Pneumology (BAPP), and the Austrian Society for Medical Mycology (ÖGMM).

Science.gov (United States)

Wiesmüller, Gerhard A; Heinzow, Birger; Aurbach, Ute; Bergmann, Karl-Christian; Bufe, Albrecht; Buzina, Walter; Cornely, Oliver A; Engelhart, Steffen; Fischer, Guido; Gabrio, Thomas; Heinz, Werner; Herr, Caroline E W; Kleine-Tebbe, Jörg; Klimek, Ludger; Köberle, Martin; Lichtnecker, Herbert; Lob-Corzilius, Thomas; Merget, Rolf; Mülleneisen, Norbert; Nowak, Dennis; Rabe, Uta; Raulf, Monika; Seidl, Hans Peter; Steiß, Jens-Oliver; Szewszyk, Regine; Thomas, Peter; Valtanen, Kerttu; Hurraß, Julia

2017-01-01

reactions. Whether or not toxin formation occurs in individual cases is determined by environmental and growth conditions, above all the substrate. In the case of indoor moisture/mould damage, everyone can be affected by odour effects and/or mood disorders. However, this is not a health hazard. Predisposing factors for odour effects can include genetic and hormonal influences, imprinting, context and adaptation effects. Predisposing factors for mood disorders may include environmental concerns, anxiety, condition, and attribution, as well as various diseases. Risk groups to be protected particularly with regard to an infection risk are persons on immunosuppression according to the classification of the German Commission for Hospital Hygiene and Infection Prevention ( Kommission für Krankenhaushygiene und Infektionsprävention, KRINKO ) at the Robert Koch- Institute (RKI) and persons with cystic fibrosis (mucoviscidosis); with regard to an allergic risk, persons with cystic fibrosis (mucoviscidosis) and patients with bronchial asthma should be protected. The rational diagnostics include the medical history, physical examination, and conventional allergy diagnostics including provocation tests if necessary; sometimes cellular test systems are indicated. In the case of mould infections the reader is referred to the AWMF guideline "Diagnosis and Therapy of Invasive Aspergillus Infections". With regard to mycotoxins, there are currently no useful and validated test procedures for clinical diagnostics. From a preventive medicine standpoint it is important that indoor mould infestation in relevant dimension cannot be tolerated for precautionary reasons. With regard to evaluating the extent of damage and selecting a remedial procedure, the reader is referred to the revised version of the mould guideline issued by the German Federal Environment Agency ( Umweltbundesamt, UBA ).

[Inadequate ICU-admissions : A 12-month prospective cohort study at a German University Hospital].

Science.gov (United States)

Bangert, K; Borch, J; Ferahli, S; Braune, S A; de Heer, G; Kluge, S

2016-05-01

Intensive care medicine (ICM) is increasingly utilized by a growing number of critically ill patients worldwide. The reasons for this are an increasingly ageing and multimorbid population and technological improvements in ICM. Inappropriate patient admissions to the intensive care unit (ICU) can be a threat to rational resource allocation and to patient autonomy. In this study, the incidence, characteristics, and resource utilization of patients inappropriately admitted to ICUs are studied. This prospective study included all consecutive patients admitted from 01 September 2012 to 31 August 2013 to the Department of Intensive Care Medicine of a German university hospital comprised of 10 ICUs and 120 beds. Inappropriate admission was defined according to category 4B of the recommendations of the Society of Critical Care Medicine (SCCM; "futility of ICU treatment" or "ICU declined by patient") and was determined in each suspected case by structured group discussions between the study team and all involved care givers including the referring team. In all, 66 of 6452 ICU admissions (1 %) were suspected to have been inappropriate on retrospective evaluation the day after admission. In 50 patients (0.8 %), an interdisciplinary consensus was reached on the inappropriateness of the ICU admission. Of these 50 patients, 41 (82 %) had previously declined ICU treatment in principle. This information was based on the patient's presumed wish as expressed by next of kin (56 %) or in a written advanced directive (26 %). In 9 patients (18 %), ICU treatment was considered futile. In all cases, a lack of information regarding a patient's wishes or clinical prognosis was the reason for inappropriate ICU admission. In this study, patients were regularly admitted to the ICU despite their contrary wish/directive or an unfavorable clinical condition. Although this was registered in only 1 % of all admissions, optimizing preICU admission information flow with regard to

Attitudes of the German general population toward early diagnosis of dementia--results of a representative telephone survey.

Directory of Open Access Journals (Sweden)

Tobias Luck

Full Text Available BACKGROUND: Early detection of dementia has clearly improved. Even though none of the currently available treatments for the most common form of dementia, Alzheimer's dementia, promises a cure, early diagnosis provides several benefits for patients, caregivers, and health care systems. This study aimed to describe attitudes toward early diagnosis of dementia in the German general population. METHODS: A representative telephone survey of the German population aged 18+ years (n = 1,002 was conducted in 2011. RESULTS: The majority of respondents (69% would be willing to be examined for early diagnosis of dementia. Almost two thirds reported that they would prefer their general practitioner (GP as the first source of professional help. More than half of the respondents (55% stated their belief that dementia could be prevented. Respondents mostly indicated psychosocial prevention options. CONCLUSIONS: Our findings suggest that the general population in Germany is very open to early diagnosis of dementia; however, this seems connected with large expectations on the effectiveness of prevention options. Dementia awareness campaigns may be employed to carefully inform the public about the prevention options currently available and their efficacy. To exploit GPs' potential as a gatekeeper for early detection of dementia, their ability to identify patients with antecedent and mild stages of the disease must be improved.

Cross-linguistic vowel variation in trilingual speakers of Saterland Frisian, Low German, and High German.

Science.gov (United States)

Peters, Jörg; Heeringa, Wilbert J; Schoormann, Heike E

2017-08-01

The present study compares the acoustic realization of Saterland Frisian, Low German, and High German vowels by trilingual speakers in the Saterland. The Saterland is a rural municipality in northwestern Germany. It offers the unique opportunity to study trilingualism with languages that differ both by their vowel inventories and by external factors, such as their social status and the autonomy of their speech communities. The objective of the study was to examine whether the trilingual speakers differ in their acoustic realizations of vowel categories shared by the three languages and whether those differences can be interpreted as effects of either the differences in the vowel systems or of external factors. Monophthongs produced in a /hVt/ frame revealed that High German vowels show the most divergent realizations in terms of vowel duration and formant frequencies, whereas Saterland Frisian and Low German vowels show small differences. These findings suggest that vowels of different languages are likely to share the same phonological space when the speech communities largely overlap, as is the case with Saterland Frisian and Low German, but may resist convergence if at least one language is shared with a larger, monolingual speech community, as is the case with High German.

Changes in air quality caused by reduced emission levels in Saxony-Anhalt. Results derived from a modern East German immission measuring system

Energy Technology Data Exchange (ETDEWEB)

Zimmermann, U. [Saxony-Anhalt State Environmental Protection Agency, Magdeburg (Germany); Roemermann, D.; Begert, V. [Saxony-Anhalt Ministry of Environment, Magdeburg (Germany). Nature Conservation and Regional Planning

1995-12-31

Specific features and main fields of construction of a telemetric immission measuring system in the East German federal state of Saxony-Anhalt are shown as a result of a very rapid development in the last three years. Immission levels and resultant enormous changes in the recent years in conjunction with the drastically changed emission situation are analysed. (author)

Changes in air quality caused by reduced emission levels in Saxony-Anhalt. Results derived from a modern East German immission measuring system

Energy Technology Data Exchange (ETDEWEB)

Zimmermann, U [Saxony-Anhalt State Environmental Protection Agency, Magdeburg (Germany); Roemermann, D; Begert, V [Saxony-Anhalt Ministry of Environment, Magdeburg (Germany). Nature Conservation and Regional Planning

1996-12-31

Specific features and main fields of construction of a telemetric immission measuring system in the East German federal state of Saxony-Anhalt are shown as a result of a very rapid development in the last three years. Immission levels and resultant enormous changes in the recent years in conjunction with the drastically changed emission situation are analysed. (author)

Excessive Profits of German Defense Contractors

Science.gov (United States)

2014-09-01

its business unit Thyssen Krupp Marine Systems, is a German defense contractor. (2) Tognom AG Tognum AG owned the MTU Friedrichshafen GmbH before... Friedrichshafen provided engines for many ships of the German Navy and for German battle tanks, such as the Leopard I and Leopard II. MTU refers to the

The German version of the Camberwell Assessment of Need for the Elderly (CANE): evaluation of content validity and adaptation to the German-speaking context.

Science.gov (United States)

Stein, Janine; Luppa, Melanie; König, Hans-Helmut; Riedel-Heller, Steffi G

2015-11-01

The Camberwell Assessment of Need for the Elderly (CANE) was developed for the assessment of physical-, psychological-, and environment-related needs in the elderly. The aim of this study was to revise and adapt the German version of the CANE with regard to the content validity of the instrument. Following a multistage approach, face-to-face interviews using the CANE, an expert survey and a multidisciplinary consensus conference were conducted in order to evaluate the frequency and relevance of met and unmet needs in the German elderly population, and to modify the content of the CANE for the German-speaking countries. In Germany, unmet physical needs including physical health, medication, eyesight/hearing/communication, mobility/falls, self-care, and continence were found to have top priority closely followed by social needs (company, intimate relationships, daytime activities, information, and abuse/neglect). Psychological needs were the lowest ranked care category. Experts' proposals for the improvement of the German version of the CANE were collected. All findings were discussed and integrated in the multidisciplinary consensus conference with the result of a revised and adapted CANE that is applicable in the German-speaking context. The provision of an adapted and improved German version of the CANE may substantially contribute to a comprehensive and valid assessment of needs in the elderly population. The results of this study represent an important basis for comprehensive needs assessment in the elderly in the theoretical and practical field of healthcare and health services research.

Enriching the Curriculum with Pennsylvania German

Science.gov (United States)

Meindl, Joerg

2016-01-01

The German classroom should prepare students for the linguistic diversity of the target culture, including regional varieties and German spoken outside of the D-A-CH region. Because textbooks do not often include materials on regional varieties, this article presents a model to incorporate Pennsylvania German (PG) into the curriculum. The model…

Steam generators. English-German, German-English. Dampferzeuger. Englisch-Deutsch, Deutsch-Englisch

Energy Technology Data Exchange (ETDEWEB)

Junge, H D

1986-01-01

This pocket dictionary contains the most important technical terms relating to steam generators both in English-German and German-English. Part of the terms go with additional definitions or explanations. Furthermore numerous examples are presented to explain the underlying rules for the formation of word combinations. In addition, entries include a number of general terms, as experience shows that suitable equivalents for use in technical texts are often needed precisely by the specialist. (HAG).

[Reimbursement of intensive care services in the German DRG system : Current problems and possible solutions].

Science.gov (United States)

Riessen, R; Hermes, C; Bodmann, K-F; Janssens, U; Markewitz, A

2018-02-01

The reimbursement of intensive care and nursing services in the German health system is based on the diagnosis-related groups (G-DRG) system. Due to the lack of a central hospital planning, the G‑DRG system has become the most important influence on the development of the German health system. Compared to other countries, intensive care in Germany is characterized by a high number of intensive care beds, a low nurse-to-patient ratio, no official definition of the level of care, and a minimal available data set from intensive care units (ICUs). Under the given circumstances, a shortage of qualified intensive care nurses and physicians is currently the largest threat for intensive care in Germany. To address these deficiencies, we suggest the following measures: (1) Integration of ICUs into the levels of care which are currently developed for emergency centers at hospitals. (2) Mandatory collection of structured data sets from all ICUs including quality criteria. (3) A reform of intensive care and nursing reimbursement under consideration of adequate staffing in the individual ICU. (4) Actions to improve ICU staffing and qualification.

Policy trends and reforms in the German DRG-based hospital payment system.

Science.gov (United States)

Klein-Hitpaß, Uwe; Scheller-Kreinsen, David

2015-03-01

A central structural point in all DRG-based hospital payment systems is the conversion of relative weights into actual payments. In this context policy makers need to address (amongst other things) (a) how the price level of DRG-payments from one period to the following period is changed and (b) whether and how hospital payments based on DRGs are to be differentiated beyond patient characteristics, e.g. by organizational, regional or state-level factors. Both policy problems can be and in international comparison often are empirically addressed. In Germany relative weights are derived from a highly sophisticated empirical cost calculation, whereas the annual changes of DRG-based payments (base rates) as well as the differentiation of DRG-based hospital payments beyond patient characteristics are not empirically addressed. Rather a complex set of regulations and quasi-market negotiations are applied. There were over the last decade also timid attempts to foster the use of empirical data to address these points. However, these reforms failed to increase the fairness, transparency and rationality of the mechanism to convert relative weights into actual DRG-based hospital payments. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Defining Multidrug Resistance of Gram-Negative Bacteria in the Dutch–German Border Region—Impact of National Guidelines

Directory of Open Access Journals (Sweden)

Robin Köck

2018-01-01

Full Text Available Preventing the spread of multidrug-resistant Gram-negative bacteria (MDRGNB is a public health priority. However, the definition of MDRGNB applied for planning infection prevention measures such as barrier precautions differs depending on national guidelines. This is particularly relevant in the Dutch–German border region, where patients are transferred between healthcare facilities located in the two different countries, because clinicians and infection control personnel must understand antibiograms indicating MDRGNB from both sides of the border and using both national guidelines. This retrospective study aimed to compare antibiograms of Gram-negative bacteria and classify them using the Dutch and German national standards for MDRGNB definition. A total of 31,787 antibiograms from six Dutch and four German hospitals were classified. Overall, 73.7% were no MDRGNB according to both guidelines. According to the Dutch and German guideline, 7772/31,787 (24.5% and 4586/31,787 (12.9% were MDRGNB, respectively (p < 0.0001. Major divergent classifications were observed for extended-spectrum β-lactamase (ESBL -producing Enterobacteriaceae, non-carbapenemase-producing carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa and Stenotrophomonas maltophilia. The observed differences show that medical staff must carefully check previous diagnostic findings when patients are transferred across the Dutch–German border, as it cannot be assumed that MDRGNB requiring special hygiene precautions are marked in the transferred antibiograms in accordance with both national guidelines.

Dictionary of radiological engineering. [English, French, and German]. Fachwoerterbuch der radiologischen Technik

Energy Technology Data Exchange (ETDEWEB)

Neuder, G F; Ullrich, H M

1980-01-01

In the present book an attempt has been made to record the current terminology in the field of radiological technology - for the present in the three languages English, German and French. It is hoped that this will contribute to a world-wide understanding amongst all those practising radiology. This is meant to include in a equal way radiologists in hospitals and private practice as well as those engaged in planning, developing, manufacturing or distributing radiological units. (orig.) 891 MG/orig. 892 MR.

The Litvinenko polonium-210 case - German experiences

International Nuclear Information System (INIS)

Kirchner, Gerald; Kroeger, Emily A.

2008-01-01

This paper brings together the measurement results taken and the lessons learned by the German Federal Office for Radiation Protection during the polonium-210 incident in Hamburg in late 2006. The incident was pivotal in confirming the importance of the defence against nuclear hazards in Germany and for highlighting the role of communication in the success of a deployment. The background of the case is reviewed and an overview of the German defence against nuclear hazards is given. The various measurement tasks, both at the scene and in the laboratory, and their results are summarized along with the communication challenges experienced. The main conclusions are that the traces of polonium-210 found at the sites were of little radiological consequence and the German defence against nuclear hazards in Germany delivered an excellent and measured response to the incident. However, communication challenges still exist and communication with the public and the emergency responders has to be given high priority during future deployments in order to ensure their success. (author)

[The challenge of adequate reimbursement for the seriously injured patient in the German DRG system].

Science.gov (United States)

Franz, D; Lefering, R; Siebert, H; Windolf, J; Roeder, N; Mahlke, L

2013-02-01

Critically injured patients are a very heterogeneous group, medically and economically. Their treatment is a major challenge for both the medical care and the appropriate financial reimbursement. Systematic underfunding can have a significant impact on the quality of patient care. In 2009 the German Trauma Society and the DRG-Research Group of the University Hospital Muenster initialised a DRG evaluation project to analyse the validity of case allocation of critically injured patients within the German DRG system versions 2008 and 2011 with additional consideration of clinical data from the trauma registry of the German Trauma Society. Severe deficits within the G-DRG structure were identified and specific solutions were designed and realised. A retrospective analysis was undertaken of standardised G-DRG data (§ 21 KHEntgG) including case-related cost data from 3 362 critically injured patients in the periods 2007 and 2008 from 10 university hospitals and 7 large municipal hospitals. For 1 241 cases of the sample, complementary detailed information was available from the trauma registry of the German Trauma Society to monitor the case allocation of critically injured patients within the G-DRG system. Analyses of coding and grouping, performance of case allocation, and the homogeneity of costs in the G-DRG versions 2008 and 2011 were done. The following situations were found: (i) systematic underfunding of trauma patients in the G-DRG-Version 2008, especially trauma patients with acute paraplegia; (ii) participation in the official G-DRG development for 2011 with 13 proposals which were largely realised; (ii) the majority of cases with cost-covering in the G-DRG version 2011; (iv) significant improvements in the quality of statistical criteria; (v) overfunded trauma patients with high intensive care costs; (vi) underfunding for clinically relevant critically injured patients not identified in the G-DRG system. The quality of the G-DRG system is measured by the

Risk factors for acute care hospital readmission in older persons in Western countries

DEFF Research Database (Denmark)

Pedersen, Mona Kyndi; Meyer, Gabriele; Uhrenfeldt, Lisbeth

2017-01-01

related to socio-demographics, health characteristics and clinical and organizational factors related to the care pathway. TYPES OF STUDIES: The current review considered analytical and descriptive epidemiological study designs that evaluated risk factors for acute care hospital readmission. OUTCOMES......: The outcome was readmission to an acute care hospital within one month of discharge. SEARCH STRATEGY: A three-step search was utilized to find published and unpublished studies in English, French, German, Norwegian, Swedish or Danish. Five electronic databases were searched from 2004 to 2013, followed...... summary and metasynthesis of the quantitative findings was conducted. RESULTS: Based on a review of nine studies from ten Western countries, we found several significant risk factors pertaining to readmission to an acute care hospital within one month of discharge in persons aged 65 years and over...

Cultural differences in postnatal quality of life among German-speaking women - a prospective survey in two countries.

Science.gov (United States)

Grylka-Baeschlin, Susanne; van Teijlingen, Edwin; Gross, Mechthild M

2014-08-15

Assessment of quality of life after childbirth is an important health-outcome measurement for new mothers and is of special interest in midwifery. The Mother-Generated Index (MGI) is a validated instrument to assess postnatal quality of life. The tool has not been applied for making a cross-cultural comparison before. This study investigated (a) responses to the MGI in German-speaking women in Germany and Switzerland; and (b) associations between MGI scores on the one hand and maternity and midwifery care on the other. A two-stage survey was conducted in two rural hospitals 10 km apart, on opposite sides of the German-Swiss border. The questionnaires included the MGI and questions on socio-demographics, physical and mental health and maternity care, and were distributed during the first days after birth and six weeks postpartum. Parametric and non-parametric tests were computed with the statistical programme SPSS. A total of 129 questionnaires were returned an average of three days after birth and 83 in the follow-up after seven weeks. There were no statistically significant differences in the MGI scores between the German and the Swiss women (p = 0.22). Significantly more favourable MGI scores were found associated with more adequate information during pregnancy (p = 0.02), a more satisfactory birth experience (p German-speaking women were higher than those in other studies reported previously. Thus the tool may be able to detect differences in postnatal quality of life among women with substantially divergent cultural backgrounds. Shortcomings in maternity and midwifery care were detected, as for example the inadequate provision of information during pregnancy, a lack of individualised postpartum care during the hospital stay and insufficient support for exclusively breastfeeding mothers. The MGI is an appropriate instrument for maternity care outcome measurement in cross-cultural comparison research.

German genes and Turkish traits: ethnicity, infertility, and reproductive politics in Germany.

Science.gov (United States)

Vanderlinden, Lisa K

2009-07-01

This ethnographic study uses the lens of ethnic difference to examine the experience of infertility and the cultural politics of belonging in modern Germany. The data are derived from participant observation and interviews conducted with forty-one ethnic Germans and thirty-three German Turks undergoing biomedical treatment for infertility at a fertility clinic in Berlin (1998-2000). Through their illness narratives, men and women symbolically link their loss of biological parenthood to losses in other life arenas, such as gender identity, social status and cultural acceptance. Results reveal that while both German Turks and ethnic Germans experience disruption and social suffering from their inability to conform to procreative norms, German Turkish sufferers exhibit higher levels of distress, which directly relates to their dual stigma as outsiders in both German Turkish culture and mainstream German culture. The findings suggest that the tensions surrounding individual reproductive practices are reflective of larger national tensions regarding the constitution of the body politic in an increasingly multicultural Germany.

Intensified colonisation screening according to the recommendations of the German Commission for Hospital Hygiene and Infectious Diseases Prevention (KRINKO): identification and containment of a Serratia marcescens outbreak in the neonatal intensive care unit, Jena, Germany, 2013-2014.

Science.gov (United States)

Dawczynski, Kristin; Proquitté, Hans; Roedel, Jürgen; Edel, Brigit; Pfeifer, Yvonne; Hoyer, Heike; Dobermann, Helke; Hagel, Stefan; Pletz, Mathias W

2016-12-01

In 2013, the German Commission for Hospital Hygiene and Infectious Disease Prevention (KRINKO) stated that extending weekly colonisation screening from very low birth weight (VLBW) infants (Serratia marcescens. Strains were typed by Pulsed Field Gel Electrophoresis (PFGE). Over 6 months, 19 out of 159 infants acquired S. marcescens. Twelve of the nineteen patients with S. marcescens were non-VLBW infants, and they were colonised significantly earlier than were VLBW infants (median 17 vs. 28 days; p marcescens.

Silent Film in the German Classroom.

Science.gov (United States)

Caldwell, David

In addition to using films in the German classroom to introduce students to German culture and history, it is important to show and study the film as film. This procedure emphasizes the importance of the film as a part of creative arts in Germany and demands student participation in observation and discussion. Many German silent films are…

Results of the scientific and humanitarian projects supported by the German electricity companies (VDEW e.V.) after the Chernobyl accident

International Nuclear Information System (INIS)

Pfob, H.; Heinemann, G.

2000-01-01

The German Electricity Companies, organized by VDEW e.V., tried to support in manifold ways the areas and people affected by the Chernobyl accident in their management of the situation. Apart from their prompting numerous help projects of the German public; we must mention three efforts especially: 1. the program for partnership in security matters initiated by the German nuclear power plants has been serving a quick and efficient support of the Eastern European plants since 1990- parallel to the efforts on a European level (strategic exchange of views of the experts concerned, consultation and training on the management level, optimization of training programs). 2: the project [Scientists Help Chernobyl Children] of the Joint Committee for Radiation Research (GAST), an union of the scientific societies working on radiation research in Germany under the chairmanship of Prof. Reiners (Essen/Wuerzburg) in cooperation with Prof. Streffer (Essen), Dr. Parezke (Munich), Dr. Heinemann (Hannover) and Dr. Pfob (Karlsruhe), aims to give humanitarian and scientific help for children ill with thyroid cancer in Belarus. Therapy and training, molecular biological examinations, dosimetry, and risk evaluation, as well as consultation and coordination in Minsk are parts of the project. 3: the project of the Radiation Cytogenetics Association (RCA) under the chairmanship of Prof. Bauchinger (GSF Muenchen) has been giving coordinated help with biological dosimetry to institutions and scientist in the states of the former USSR. Through retrospective biological dosimetry, especially the employment of the FISH (fluorescence in situ hybridization)-technology for the assessment of so-called stable translocations, both individual and population doses were analyzed. All three of these projects, even if to a different extent, have been leading to new and unique results up to the present day. Especially the GAST-project has been marked to a high extent by its humanitarian help for the

Unmet supportive care needs: a cross-cultural comparison between Hong Kong Chinese and German Caucasian women with breast cancer.

Science.gov (United States)

Lam, Wendy W T; Au, Angel H Y; Wong, Jennifer H F; Lehmann, Claudia; Koch, Uwe; Fielding, Richard; Mehnert, Anja

2011-11-01

The comparison of psychosocial needs across different cultural settings can identify cultural and service impacts on psychosocial outcomes. We compare psychosocial needs in Hong Kong Chinese and German Caucasian women with breast cancer. Completed questionnaires were collected from 348 Chinese and 292 German women with breast cancer for assessing unmet psychosocial needs (Supportive Care Needs Survey Short Form), psychological distress (the Hospital Anxiety and Depression scale), and listed physical and psychological symptoms. Only 11% of the participants reported not needing help for any of the 34 items. More German (14%) than Chinese women (8%) reported no unmet needs (χ(2) = 6.16, P = .013). With both samples combined, the Health System and Information domain unmet needs were the most prevalent, apart from one Psychological need domain item, "Fear about the cancer spreading." Chinese and German samples differed significantly in prevalence and patterns of unmet psychosocial needs. Multivariate adjustment for demographic, clinical, and sample characteristics, psychological distress, and symptoms showed that significantly greater unmet Health system and Information, and Patient care and support domain needs, associated with the presence of symptoms (β = .232, P German group membership, among others. German women reported more anxiety (t = 10.45, P German, but not Chinese women reporting greater anxiety and depression had greater unmet Psychological and Sexuality domain needs (P culture-specific differences in supportive care needs exist. Hong Kong Chinese women prioritize needs for information about their disease and treatment, whereas German Caucasian women prioritize physical and psychological support. Planning for cancer supportive care services or interventions to reduce unmet needs must consider cultural and/or health service contexts.

German Idealism Today

DEFF Research Database (Denmark)

This collection of essays provides an exemplary overwiew of the diversity and relevance of current scholarship on German Idealism. The importance of German Idealism for contemporary philosophy has recieved growing attention and acknowledgment throughout competing fields of contemporary philosophy...... scholarly debates beyond merely antiquarian perspectives. This renaissance has been a major factor of current efforts to bridge the gap between so-called "nalytic" and so-called "continental" philosophy. The volume provides a selection of readings that contributes to systematic treatments of philosophical...

Revitalization of ethnic identity among the Germans in Sremski Karlovci

Directory of Open Access Journals (Sweden)

Krel Aleksandar

2009-01-01

Full Text Available During the 1990's, many members of the German national minority have awaken from the several decades long sleep in 'ethnic hibernation'. Several associations have been founded at that time, with an aim to gather and encourage ethnic feelings of the Germans living in Vojvodina. These associations work toward revitalization and reconstruction of the German ethnic and cultural identity. There are quite a few of such institutions today, and one of them is German association promoting good neighbor relations Karlowitz, Sremski Karlovci. This paper will discuss transformation of an ethnic identity strategy among the Germans in Sremski Karlovci; in addition, I will analyze modus operandi by which this local association aims at keeping and encouraging certain elements of the ethnic and cultural particulars. The results of the research point out how a relatively small group, without social power, can define and redefine its own identity, in regards to historical, social and economic conditions.

A simple route to synthesize manganese germanate nanorods

International Nuclear Information System (INIS)

Pei, L.Z.; Yang, Y.; Yuan, C.Z.; Duan Taike; Zhang Qianfeng

2011-01-01

Manganese germanate nanorods have been synthesized by a simple route using germanium dioxide and manganese acetate as the source materials. X-ray diffraction observation shows that the nanorods are composed of orthorhombic and monoclinic manganese germanate phases. Scanning electron microscopy and transmission electron microscopy observations display that the manganese germanate nanorods have flat tips with the length of longer than 10 micrometers and diameter of 60-350 nm, respectively. The role of the growth conditions on the formation of the manganese germanate nanorods shows that the proper selection and combination of the growth conditions are the key factor for controlling the formation of the manganese germanate nanorods. The photoluminescence spectrum of the manganese germanate nanorods exhibits four fluorescence emission peaks centered at 422 nm, 472 nm, 487 nm and 530 nm showing the application potential for the optical devices. - Research Highlights: → Manganese germanate nanorods have been synthesized by simple hydrothermal process. → The formation of manganese germanate nanorods can be controlled by growth conditions. → Manganese germanate nanorods exhibit good PL emission ability for optical device.

OPPOSITIVE METAPHORICAL MODELS IN THE GERMAN POLITICAL DISCOURSE

Directory of Open Access Journals (Sweden)

Tameryan, T.Yu.

2016-06-01

Full Text Available The paper deals with the analysis of German Chancellor Angela Merkel’s metaphoric image in the German press. As a result of analysis 8 binary metaphorical constructions, verbalized by two components, one of which is positively marked (PM, the other one have been negatively (NM identified. Statistical analysis of the linguistic material allowed to conclude that the assessment of Merkel is ambivalently with a slight predominance of positive estimation.

New German abortion law agreed.

Science.gov (United States)

Karcher, H L

1995-07-15

The German Bundestag has passed a compromise abortion law that makes an abortion performed within the first three months of pregnancy an unlawful but unpunishable act if the woman has sought independent counseling first. Article 218 of the German penal code, which was established in 1871 under Otto von Bismarck, had allowed abortions for certain medical or ethical reasons. After the end of the first world war, the Social Democrats tried to legalize all abortions performed in the first three months of pregnancy, but failed. In 1974, abortion on demand during the first 12 weeks was declared legal and unpunishable under the social liberal coalition government of chancellor Willy Brandt; however, the same year, the German Federal Constitution Court in Karlsruhe ruled the bill was incompatible with article 2 of the constitution, which guarantees the right to life and freedom from bodily harm to everyone, including the unborn. The highest German court also ruled that a pregnant woman had to seek a second opinion from an independent doctor before undergoing an abortion. A new, extended article 218, which included a clause giving social indications, was passed by the Bundestag. When Germany was unified, East Germans agreed to be governed by all West German laws, except article 218. The Bundestag was given 2 years to revise the article; however, in 1993, the Federal Constitution Court rejected a version legalizing abortion in the first 3 months of the pregnancy if the woman sought counsel from an independent physician, and suggested the recent compromise passed by the Bundestag, the lower house of the German parliament. The upper house, the Bundesrat, where the Social Democrats are in the majority, still has to pass it. Under the bill passed by the Bundestag, national health insurance will pay for an abortion if the monthly income of the woman seeking the abortion falls under a certain limit.

THE PLIGHT OF GERMAN MISSIONS IN MANDATE CAMEROON: AN HISTORICAL ANALYSIS

Directory of Open Access Journals (Sweden)

Lang Michael Kpughe

2017-09-01

Full Text Available The First World War and its resultant Mandate and Trusteeship systems greatly affected the German mission enterprise in Cameroon. Apart from causing the forceful ousting of German missionaries from Cameroon, the British and the French whom the League of Nations and United Nations successively chose as administering powers within the Mandate and Trusteeship frameworks adopted hostile policies towards German missions. From the beginning of the war to the post-Second World War era, the foundation of German missions was seriously threatened. This paper critically examines the treatment of German missions in both British and French Cameroons during the Mandate and Trusteeship periods, focusing especially on the opposing attitudes of both administering powers towards the missions in their spheres of influence. The paper establishes that the administering powers’ treatment of German missions, which was underpinned by imperial and nationalist exigencies, roiled the attainment of the triple missionization agenda of planting self-supporting, self-governing and self-evangelizing churches. It thus argues that the First World War triggered the mistreatment of German missions, with some missions forced to terminate their activities while others were allowed to continue their mission work under difficult conditions.

Integrated Marketing Strategies of German Companies : Start-Ups vs. Global Brands

OpenAIRE

Kostin, Irina

2016-01-01

The purpose of this bachelor's thesis is to find out and analyze different marketing strategies of German fashion companies. The main part is comparing relatively young start-up companies to established companies and analyzing to what extent the strategies differ. The methodology used in this paper were semi-structured expert interviews with German start-up companies. The results were analyzed and compared to the secondary research on the big global German companies. The findings showed that ...

Psychiatric comorbidity in alcohol use disorders: results from the German S3 guidelines.

Science.gov (United States)

Preuss, U W; Gouzoulis-Mayfrank, E; Havemann-Reinecke, U; Schäfer, I; Beutel, M; Hoch, E; Mann, K F

2018-04-01

Alcohol use disorders (AUD) have a high comorbidity with mental disorders. Vice versa, alcohol consumption plays an important role in affective disorders, anxiety disorders, ADHD, schizophrenic psychosis, and other mental disorders. In developing the current interdisciplinary, evidence-based treatment guideline on screening, diagnostics, and treatment of AUD, available research on comorbid mental diseases in AUD has been compiled to generate recommendations for treatment. The guideline was prepared under the responsibility of the German Association for Psychiatry, Psychotherapy, and Psychosomatics (DGPPN) and the German Association for Addiction Research and Therapy (DG-Sucht). To meet the methodological criteria for the highest quality guidelines ("S3-criteria") as defined by the Association of Scientific Medical Societies in Germany (AWMF), the following criteria were employed: (1) a systematic search, selection, and appraisal of the international literature; (2) a structured process to reach consensus; and (3) inclusion of all relevant representatives of future guideline users. After assessing and grading the available literature, the expert groups generated several recommendations for the screening, diagnosis, and treatment of comorbid mental disorders. These recommendations were subdivided into psycho-, pharmaco-, and combination therapies. These are the first guidelines ever to make specific treatment recommendations for comorbid mental diseases in AUD. The recommendations extend to different treatment approaches including diagnostics and settings to present available effective and state-of-the-art treatment approaches to clinicians. Hitherto, many clinical constellations have not been addressed in research. Therefore, recommendations for future research are specified.

Sport Engagement by Accelerometry under Field Conditions in German Adolescents: Results from GINIPlus.

Science.gov (United States)

Smith, Maia; Berdel, Dietrich; Nowak, Dennis; Heinrich, Joachim; Schulz, Holger

2015-01-01

Sporting activities differ in their ability to promote moderate-to-vigorous physical activity (MVPA). To assess adolescents' engagement in sport under field conditions we used accelerometers to measure their MVPA levels during sport. We pay special attention to differences between team and individual sport and between common sports. Diary data and 7-day accelerometry from 1054 Germans ages 15-17 were combined to measure physical activity. 1373 diaried episodes of more than 40 common sports were identified from 626 participants and grouped into team and individual sport. We modeled the effect of team and individual sport, and described levels of MVPA and episodes of no MVPA for all recorded sports. German boys and girls averaged 43 (SD 21) and 37 (SD 24) minutes MVPA per day. Boys got 2.2 times as much MVPA per minute during team compared to individual sport (psport ranged from 6% for weight training to 74% for jogging, with individual sports averaging 10-30% and team sports 30-50%. 11% of sport episodes had no MVPA: half of episodes of cycling, 5% of jogging, and none for tennis or badminton. An episode of individual sport was 17 times more likely to have no MVPA than an episode of team sport (psporting time. As measured by accelerometry, individual sport often produced no MVPA. Characteristics of the sport, such as team vs. individual, were more predictive of MVPA than were characteristics of the participant, such as background activity levels.

Acquisition of German Pluralization Rules in Monolingual and Multilingual Children

Science.gov (United States)

Zaretsky, Eugen; Lange, Benjamin P.; Euler, Harald A.; Neumann, Katrin

2013-01-01

Existing studies on plural acquisition in German have relied on small samples and thus hardly deliver generalizable and differentiated results. Here, overgeneralizations of certain plural allomorphs and other tendencies in the acquisition of German plural markers are described on the basis of test data from 7,394 3- to 5-year-old monolingual…

Dividend Policy of German Firms

NARCIS (Netherlands)

Goergen, M.; Renneboog, L.D.R.; Correia Da Silva, L.

2004-01-01

German firms pay out a lower proportion of their cash flows than UK and US firms.However, on a published profits basis, the pattern is reversed.Company law provisions and accounting policies account for these conflicting results.A partial adjustment model is used to estimate the implicit target

African Americans Who Teach German Language and Culture.

Science.gov (United States)

Fikes, Robert Jr.

2001-01-01

A large number of black scholars have pursued advanced degrees in the German language, history, and culture. Describes the history of African American interest in the German language and culture, highlighting various black scholars who have studied German over the years. Presents data on African Americans in German graduate programs and examines…

Neurogenetic evidence in the courtroom: a randomised controlled trial with German judges.

Science.gov (United States)

Fuss, Johannes; Dressing, Harald; Briken, Peer

2015-11-01

Prominent court decisions and recent research suggest that introduction of neurogenetic evidence, for example, monoamine oxidase A alleles, may reduce the sentence of convicted psychopaths. Here, we are aiming to demonstrate that judges' response to neurogenetic evidence is highly influenced by the legal system in which they operate. Participating German judges (n=372) received a hypothetical case vignette of aggravated battery, and were randomly assigned to expert testimonies that either involved a neurogenetic explanation of the offender's psychopathy or only a psychiatric diagnosis of psychopathy. Testimonies were presented either by the prosecution or defence. Neurogenetic evidence significantly reduced judges' estimation of legal responsibility of the convict. Nevertheless, the average prison sentence was not affected in the German legal system. Most interestingly, analysis of judges' reasoning revealed that neurogenetic arguments presented by the prosecution significantly increased the number of judges (23% compared with ∼ 6%) ordering an involuntary commitment in a forensic psychiatric hospital. Such an involuntary commitment due to diminished or absent legal responsibility may last much longer than a prison sentence in the German legal system. Our data, thus, demonstrate the socially contingent nature of legal responses to neurogenetic evidence in criminal cases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

94th German Roentgen congress. Program and abstracts

International Nuclear Information System (INIS)

2013-01-01

The volume includes the abstracts of the 94th German Roentgen congress concerning the following topics: Interventional oncology; mammary carcinoma; medical care and imaging; news in radio-oncology; regional therapy of lung malign tumors; medical ontology intelligent searching strategy; image fusion; oncology - imaging in screening; cardiovascular emergency - an update; innovations in the physics of radiology; risk management and budget; mobile computing; mammary diagnostics; elucidation and liability benchmarking in radiology; cost and performance in the medical office; research: innovation or self-purpose; cost refunding PET/CT and MRT PET; economic strategy in health care; options of radiological practice in medical offices and hospitals; trends in imaging; radiological diagnostics in emergency cases; X-ray regulations; neuroradiology; muscuskeletal radiology; chest radiology; pediatric radiology, radiation protection for the medical personnel.

German energy market 2016

International Nuclear Information System (INIS)

Schiffer, Hans-Wilhelm; Weltenergierat, Berlin

2017-01-01

The basic orientation of the German energy supply to the increased use of renewable energies, while increasing energy efficiency, is prediscribed by the German government's energy concept and determines the market development. A current overview of the German energy market is given, which provides also this year a concentrated Compilation of the key data of the energy industry. As in the years before, the article not only summarizes general facts about the energy mix, but also goes into detail on the development of the individual energy sources, petroleum, natural gas, brown coal and hard coal, electricity as well as renewable energies. Furthermore, the price trends of international markets and in the domestic market are explained. A current overview of the development of greenhouse gas emissions concludes the contribution. [de

[The Jewish Hospital in Budapest under the Nazi occupation (1944-1945)].

Science.gov (United States)

Weisskopf, Varda

2008-01-01

On March 19, 1944 the German army invaded and occupied Hungary. The Waffen-SS soldiers captured the buildings of the Jewish community in Budapest, including the famous and important Jewish hospital on Szabolcs Street, founded in 1802. The Jewish hospital moved into a school belonging to the Jewish community on 44 Wesselényi Street. The hospital personnel managed to smuggle out medical equipment, and operating rooms were transferred into this central, temporary medical location. Other hospitals were founded, some inside the ghetto, others outside. The Judenrat supplied these hospitals with medical equipment obtained through contributions from Jews. The temporary hospitals admitted sick patients and a great number of those injured as a result of the war in Budapest. These hospitals operated with poor equipment. Surgeries were sometimes performed on kitchen tables, and medical equipment was sterilized by burning the synagogue's benches and library books. As of December 1944, there was no electricity in the hospitals. Thus doctors were forced to operate by the light of candles and flashlights. Nevertheless, they managed to save numerous lives. In spite of the terrible conditions under which the medical staff worked, they were committed to their mission, and their courage deserves appreciation. Ghetto Budapest was liberated by the Red army on 18th January, 1945. Thousands of Jews were released from the temporary hospitals.

Male suicide rates in German prisons and the role of citizenship

Science.gov (United States)

Lempp, Thomas; Kettner, Mattias; Rauf, Amna; Bennefeld-Kersten, Katharina; Freitag, Christine M.

2017-01-01

Purpose Prisoners are at a particularly high risk of suicide. In contrast to other psychosocial risk factors it remains unclear to what degree the risk of suicide differs between prisoners with local citizenship and foreigners. In order to provide more detailed information for suicide prevention in prisons, this study aims to compare suicide rates (SR) between these populations in German criminal custody. Methods Based on a German national database of completed suicide in custody, suicides by prisoners were analysed and compared with epidemiological data of the prison population and the general population, stratified for German and foreign citizenship. Data analysis was adjusted for differences in the age distribution of both populations by calculating standard mortality ratios (SMR) for suicide. Results SR were higher in prisoners with German citizenship than those with foreign citizenship (SR = 76.5 vs. SR = 42.8, Pcitizenship was comparable in juvenile and adult prisoners, indicating its relevance to both the juvenile and adult detention systems. Conclusion Imprisonment is associated with a substantially increased risk of suicide in both German and non-German citizens, a finding which needs to be taken into consideration by the justice system. The lower suicide risk in non-German citizens is independent of whether or not they are in custody. PMID:28591187

Malnutrition in hospitalized patients: results from La Rioja.

Science.gov (United States)

Martín Palmero, Ángela; Serrano Pérez, Andra; Chinchetru Ranedo, Mª José; Cámara Balda, Alejandro; Martínez de Salinas Santamarí, Mª Ángeles; Villar García, Gonzalo; Marín Lizárraga, Mª Del Mar

2017-03-30

There is a high malnutrition prevalence in hospitalized patients. To determine the malnutrition prevalence in hospitalized patients of La Rioja Community (Spain) when evaluated with different screening/ evaluation tools and its relationship with hospital stay and mortality. Cross sectional observational study of hospitalized adult patients (age > 18 years old) from medical and surgical departments that underwent within 72 h of their admission a nutritional screening with Malnutrition Universal Screening Tool (MUST), Nutritional Risk Screening (NRS) 2002, Controlling Nutritional Status (CONUT) y Subjective Global Assessment (SGA). 384 patients (273 medical and 111 surgical) were evaluated. Almost fifty percent of them were considered malnourished independently of the screening/assessment tool used. High concordance was found between SGA and NRS-2002 (k = 0.758). Malnourished patients had a longer hospital stay than those well-nourished (9.29 vs. 7.10 days; p = 0.002), used a greater number of medicines (9.2 vs. 7.4; p = 0.001) and underwent a higher number of diagnostic tests (16.4 vs. 12.5; p = 0,002). Half of the hospitalized patients in the medical and surgical department of La Rioja are malnourished. This is associated with a longer hospital stay, higher use of medicines, diagnostics tests and greater mortality. Malnutrition could be detected with easy screening tools to treat it appropriately.

Understanding hospital cafeterias: results from cafeteria manager interviews.

Science.gov (United States)

Lederer, Ashley; Toner, Cassiopeia; Krepp, Erica M; Curtis, Christine J

2014-01-01

To describe the characteristics, nutrition-related knowledge, practices, and attitudes of staff managing cafeterias in New York City (NYC) hospitals. An in-person survey was administered over 7 months to cafeteria managers from hospitals participating in the NYC Department of Health and Mental Hygiene's Healthy Hospital Food Initiative. The survey assessed nutrition knowledge and attitudes; hospital cafeteria practices; and nutrition standards and policies. The majority of questions required a yes or no response, followed by an open-ended request for details related to the response. Other questions were multiple choice or used 5-point Likert scales to measure respondent perceptions. Seventeen cafeteria managers completed the survey. Less than a third of respondents had training in nutrition, and less than a quarter of hospitals followed nutrition standards for food offered in the cafeteria. Most respondents thought cafeterias could play a role in reducing sodium consumption, yet less than half correctly identified the largest sources of sodium in the average diet. The most commonly cited limitation to making healthy changes in the cafeteria was perceived lack of demand for healthy foods/customer support. Characteristics, nutrition knowledge, practices, and attitudes of hospital cafeteria managers vary. Communication with consumers and education of staff who lack training and experience in nutrition may be important focus areas for hospitals looking to improve their food environment.

Estimation of hospital efficiency--do different definitions and casemix measures for hospital output affect the results?

Science.gov (United States)

Vitikainen, Kirsi; Street, Andrew; Linna, Miika

2009-02-01

Hospital efficiency has been the subject of numerous health economics studies, but there is little evidence on how the chosen output and casemix measures affect the efficiency results. The aim of this study is to examine the robustness of efficiency results due to these factors. Comparison is made between activities and episode output measures, and two different output grouping systems (Classic and FullDRG). Non-parametric data envelopment analysis is used as an analysis technique. The data consist of all public acute care hospitals in Finland in 2005 (n=40). Efficiency estimates were not found to be highly sensitive to the choice between episode and activity descriptions of output, but more so to the choice of DRG grouping system. Estimates are most sensitive to scale assumptions, with evidence of decreasing returns to scale in larger hospitals. Episode measures are generally to be preferred to activity measures because these better capture the patient pathway, while FullDRGs are preferred to Classic DRGs particularly because of the better description of outpatient output in the former grouping system. Attention should be paid to reducing the extent of scale inefficiency in Finland.

Environmental aspects of hydraulic fracturing - Main results and recommendations from two studies on behalf of the German Environment Agency

Science.gov (United States)

Krischbaum, Bernd; Bertram, Andreas; Böttcher, Christian; Iyimen-Schwarz, Züleyha; Rechenberg, Jörg; Dannwolf, Uwe; Meiners, Georg

2016-04-01

The German Environment Agency (UBA) accompanies the debate on fracking for years. Two major reports on risks and environmental impacts regarding the exploration and exploitation of unconventional natural gas, in particular shale gas have been published. On the basis of these studies as well as on scientific evidence UBA considers ecological barriers as a sustainable means to minimize the risks to environment and human health. 1) Recent studies show that the contamination of shallow aquifers by rise of fluids through natural faults or artificially created fractures is extremely unlikely. However, activities on the surface and lack of wellbore integrity pose threats and substantial risks for the quality of shallow aquifers. 2) The need for thorough groundwater monitoring is fully accepted, yet its range and design is subject to discussion. 3) Formerly, analysis and mass balances of flowback and produced water have been insufficient, thus there is a lack of exact information on proportions of frac-fluids, flowback and formation water respectively, as well as data on possible reaction products. 4) Currently, neither on national nor on European level best reference techniques (BREF) for the treatment and disposal of flowback and produced water are available. 5) In addition, land consumption, emission of greenhouse gases, and induced seismicity are major issues. UBA recommends amongst others the implementation of an environmental impact assessment (EIA) for fracking activities, the prohibition of fracking in water protection areas as well as their catchments, and the disclosure of all frac-fluid chemicals within a national chemical registry. To achieve these objectives the German Environment Agency suggests a step-by-step approach. The paper will present the main results from the studies and the recommendations of the German Environment Agency regarding hydraulic fracturing for unconventional gas exploitation.

Organizational capacities for health promotion implementation: results from an international hospital study.

Science.gov (United States)

Röthlin, Florian; Schmied, Hermann; Dietscher, Christina

2015-06-01

In this article, organizational structures in hospitals are discussed as possible capacities for hospital health promotion (HP) implementation, based on data from the PRICES-HPH study. PRICES-HPH is a cross-sectional evaluation study of the International Network of Health Promoting Hospitals & Health Services (HPH-Network) and was conducted in 2008-2012. Data from 159 acute care hospitals were used in the analysis. Twelve organizational structures, which were denoted as possible organizational health promotion capacities in previous literature, were tested for their association with certain strategic HP implementation approaches. Four organizational structures were significantly (p = 0.05) associated with one or more elaborate and comprehensive strategic HP implementation approaches: (1) a health promotion specific quality assessment routine; (2) an official hospital health promotion team; (3) a fulltime hospital health promotion coordinator; and (4) officially documented health promotion policies, strategies or standards. The results add further evidence to the importance of organizational capacity structures for hospital health promotion and identify four tangible structures as likely candidates for organizational HP capacities in hospitals. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Malnutrition and dementia in the elderly in German nursing homes. Results of a prevalence survey from the years 2008 and 2009].

Science.gov (United States)

Reuther, S; van Nie, N; Meijers, J; Halfens, R; Bartholomeyczik, S

2013-04-01

Dementia is one of most challenging problems for the care of older people in Germany. Although malnutrition in nursing homes is also associated with dementia, few systematic studies have described health care structures in German nursing homes for people with dementia and their individual nutritional status. Therefore, the aim of this study was to determine dementia-specific differences concerning the nutrition situation for the elderly in German nursing homes. A cross-sectional multicenter study was performed using a standardized multilevel instrument (observation, questionnaire) developed at the University of Maastricht. Variables are indicators for malnutrition and its risks, quality indicators, care dependency and types of interventions. In the 2008 and 2009 surveys, 53% of 4,777 participants (77.9% women, 22.1% men, mean age 82 years) were identified (based on care documentation) as having dementia. More than one third of this population (n = 759, 85.1% women, 14.1% men, mean age 85 years) was probably malnourished; thus, the prevalence rate in the group of people with dementia was 10% higher compared to the group without dementia. People with dementia showed a higher risk in all relevant risk indicators (weight history, body mass index, and food intake) for malnutrition compared to those without dementia. Furthermore, people with dementia had higher care dependency rates and required more assistance for eating and drinking. The study results confirm the relationship between malnutrition and dementia. The use of standardized nutrition screening tools is not common practice in German nursing homes yet. However, the results suggest that with an increasing risk for malnutrition combined with dementia the proportion of nursing interventions also increases, which means that nurses must react adequately. Nevertheless, the interventions concerning malnutrition should be improved especially with respect to preventive measurements.

A Suggested Curriculum Outline for German in Secondary Schools

Science.gov (United States)

Clutterbuck, J. M.

1975-01-01

Outlines a four-year program of German study aiming to give students a basic ability in spoken and written German, knowledge of German culture, and preparation for advanced German study. Study topics and textbooks are included. (CHK)

Reducing barriers to energy efficiency in the German brewing sector. Final report

Energy Technology Data Exchange (ETDEWEB)

Schleich, J; Boede, U; Ostertag, K; Radgen, P

2000-12-01

This report describes the empirical research into barriers to energy efficiency in the German brewing sector. It is one of nine such reports in the BARRIERS project. The report contains description and analysis of five case studies of energy management in German breweries. The results are analysed using the theoretical framework developed for the BARRIERS project. The report also provides brief recommendations on how these barriers to the rational use of energy (RUE) may be overcome and how energy efficiency within the brewing sector may be improved. The results of the study for the brewing sector in Germany are summarised in this executive summary under the following headings: - Characterising the brewing sector - Case studies of energy management in the German brewing sector; - Evidence of barriers in the German brewing sector; - The role of energy service companies in the brewing sector; - Policy implications. (orig.)

Reducing barriers to energy efficiency in the German brewing sector. Executive Summary

Energy Technology Data Exchange (ETDEWEB)

Schleich, J.; Boede, U.; Ostertag, K.; Radgen, P.

2000-12-01

This report describes the empirical research into barriers to energy efficiency in the German brewing sector. It is one of nine such reports in the BARRIERS project. The report contains description and analysis of five case studies of energy management in German breweries. The results are analysed using the theoretical framework developed for the BARRIERS project. The report also provides brief recommendations on how these barriers to the rational use of energy (RUE) may be overcome and how energy efficiency within the brewing sector may be improved. The results of the study for the brewing sector in Germany are summarised in this executive summary under the following headings: - Characterising the brewing sector; - Case studies of energy management in the German brewing sector; - Evidence of barriers in the German brewing sector; - The role of energy service companies in the brewing sector; - Policy implications. (orig.)

[Strategic planning: an important economic action for German hospitals].

Science.gov (United States)

Wiese, Christoph H R; Zink, Wolfgang; Russo, Sebastian G

2011-11-01

In medical systems, economic issues and means of action are in the course of dwindling human (physicians and nurses) and financial resources are more important. For this reason, physicians must understand basic economic principles. Only in this way, there may be medical autonomy from social systems and hospital administrators. The current work is an approach to present a model for strategic planning of an anesthesia department. For this, a "strengths", "weaknesses", "opportunities", and "threats" (SWOT) analysis is used. This display is an example of an exemplary anaesthetic department. © Georg Thieme Verlag Stuttgart · New York.

How old are Germanic lambs?

DEFF Research Database (Denmark)

Vrieland, Seán D.

2017-01-01

Gothic and Gutnish lamb with the meaning ‘sheep’ sets these two languages apart from the rest of Germanic, and is the most common piece of evidence used to claim they share a close connection. Yet the same meaning is found in the descendants of Proto-Fennic *lambaz, a loan from Proto-Germanic, an......Gothic and Gutnish lamb with the meaning ‘sheep’ sets these two languages apart from the rest of Germanic, and is the most common piece of evidence used to claim they share a close connection. Yet the same meaning is found in the descendants of Proto-Fennic *lambaz, a loan from Proto...

[Patient safety culture in hospitals: experiences in planning, organising and conducting a survey among hospital staff].

Science.gov (United States)

van Vegten, Amanda; Pfeiffer, Yvonne; Giuliani, Francesca; Manser, Tanja

2011-01-01

This article presents the first hospital-wide survey on patient safety climate, involving all staff (medical and non-medical), in the German-speaking area. Its aim is to share our experiences with planning, organising and conducting this survey. The study was performed at the university hospital in Zurich and had a response rate of 46.8% (2,897 valid questionnaires). The survey instrument ("Patientensicherheitsklimainventar") was based on the Hospital Survey on Patient Safety Culture (AHRQ). Primarily it allowed for assessing the current patient safety climate as well as identifying specific areas for improvement and creating a hospital-wide awareness and acceptance for patient safety issues and interventions (e.g., the introduction of a Critical Incident Reporting System [CIRS]). We discuss the basic principles and the feedback concept guiding the organisation of the overall project. Critical to the success of this project were the guaranteed anonymity of the respondents, adequate communication through well-established channels within the organisation and the commitment of the management across all project phases. Copyright © 2011. Published by Elsevier GmbH.

Exposure to second-hand smoke and direct healthcare costs in children – results from two German birth cohorts, GINIplus and LISAplus

Directory of Open Access Journals (Sweden)

Batscheider Ariane

2012-10-01

Full Text Available Abstract Background Although the negative health consequences of the exposure to second hand tobacco smoke during childhood are already known, evidence on the economic consequences is still rare. The aim of this study was to estimate excess healthcare costs of exposure to tobacco smoke in German children. Methods The study is based on data from two birth cohort studies of 3,518 children aged 9-11 years with information on healthcare utilisation and tobacco smoke exposure: the GINIplus study (German Infant Study On The Influence Of Nutrition Intervention Plus Environmental And Genetic Influences On Allergy Development and the LISAplus study (Influence of Life-Style Factors On The Development Of The Immune System And Allergies In East And West Germany Plus The Influence Of Traffic Emissions And Genetics. Direct medical costs were estimated using a bottom-up approach (base year 2007. We investigated the impact of tobacco smoke exposure in different environments on the main components of direct healthcare costs using descriptive analysis and a multivariate two-step regression analysis. Results Descriptive analysis showed that average annual medical costs (physician visits, physical therapy and hospital treatment were considerably higher for children exposed to second-hand tobacco smoke at home (indoors or on patio/balcony compared with those who were not exposed. Regression analysis confirmed these descriptive trends: the odds of positive costs and the amount of total costs are significantly elevated for children exposed to tobacco smoke at home after adjusting for confounding variables. Combining the two steps of the regression model shows smoking attributable total costs per child exposed at home of €87 [10–165] (patio/balcony and €144 [6–305] (indoors compared to those with no exposure. Children not exposed at home but in other places showed only a small, but not significant, difference in total costs compared to those with no exposure

Risk-oriented analysis on the German prototype fast breeder reactor SNR-300

International Nuclear Information System (INIS)

Bayer, A.; Koeberlein, K.; Gesellschaft fuer Reaktorsicherheit, Garching, Germany)

1984-01-01

On request of a fact-finding committee of the German Federal Parliament, a risk-oriented analysis on the SNR-300, the German prototype fast breeder reactor, has been performed to allow a pragmatic safety comparison of the SNR-300 and a modern light-water reactor. Results of the technical plant analysis have been summarized in seven release categories. Accident consequences have been calculated for the actual site at Kalkar/Rhine. The results indicate that for the SNR-300 both the frequency of major accidents and the consequences of accidents are smaller than for the pressurized-water reactor analyzed in the German Risk Study. This article summarizes the methods and main results of the analysis of the SNR-300

Cash Holdings and Leverage of German Listed Firms

DEFF Research Database (Denmark)

Rapp, Marc Steffen; Killi, Andreas Maximilian

2016-01-01

We examine cash holdings and leverage levels of German listed (non-financial and non-utility) firms. We document a secular increase in cash ratios over the last twenty years (1992–2011), reducing the net debt book leverage ratio for the average sample firm close to zero. Using prediction models...... firms are associated with measures of uncertainty faced by firms. Our results suggest that German firms have increased (reduced) their cash (net debt leverage) levels over time in order to adopt more precautionary financial policies....

German Vocabulary.

Science.gov (United States)

Coombs, Virginia M.

This article discusses in general terms derivational aspects of English vocabulary. Citing examples of Anglo-Saxon origin, the author provides a glimpse into the nature of the interrelatedness of English, German, and French vocabulary. (RL)

Decision Criteria for German Hardwood Lumber Buyers: Market Needs and Purchase

Science.gov (United States)

Thomas G. Ponzurick; Robert J. Bush; Dieter Schaupp; Philip A. Araman

1993-01-01

The purpose of this study was to develop a better understanding of hardwood exports to the German market. A mail survey was conducted which resulted in a 47.8 percent rate of response. Of those German hardwood buyers responding to the survey, 71 percent purchased hardwood lumber directly from North America.

Endangering of Businesses by the German Inheritance Tax? – An Empirical Analysis

OpenAIRE

Houben, Henriette; Maiterth, Ralf

2011-01-01

This contribution addresses the substantial tax privilege for businesses introduced by the German Inheritance Tax Act 2009. Advocates of the vast or even entire tax exemption for businesses stress the potential damage of the inheritance tax on businesses, as those often lack liquidity to meet tax liability. This submission tackles this issue empirically based on data of the German Inheritance Tax Statistics and the SOEP. The results indicate that former German inheritance tax law has not enda...

Health-related quality of life of prostate cancer patients compared to the general German population: age-specific results.

Science.gov (United States)

Zenger, Markus; Hinz, Andreas; Stolzenburg, Jens-Uwe; Rabenalt, Robert; Schwalenberg, Thilo; Schwarz, Reinhold

2009-01-01

The objective of this study was to examine the age-specific health-related quality of life (HRQOL) of prostate cancer patients (PCPs). 387 PCPs were asked to self-assess their HRQOL with the EORTC QLQ-C30 questionnaire. Patients' data were compared with those of the general German population. The reported global health/QOL scores of the study group and the general German population are nearly equal. However, most of the subdomains of HRQOL are negatively affected in PCPs, especially in younger patients (

Process-based organization design and hospital efficiency.

Science.gov (United States)

Vera, Antonio; Kuntz, Ludwig

2007-01-01

The central idea of process-based organization design is that organizing a firm around core business processes leads to cost reductions and quality improvements. We investigated theoretically and empirically whether the implementation of a process-based organization design is advisable in hospitals. The data came from a database compiled by the Statistical Office of the German federal state of Rheinland-Pfalz and from a written questionnaire, which was sent to the chief executive officers (CEOs) of all 92 hospitals in this federal state. We used data envelopment analysis (DEA) to measure hospital efficiency, and factor analysis and regression analysis to test our hypothesis. Our principal finding is that a high degree of process-based organization has a moderate but significant positive effect on the efficiency of hospitals. The main implication is that hospitals should implement a process-based organization to improve their efficiency. However, to actually achieve positive effects on efficiency, it is of paramount importance to observe some implementation rules, in particular to mobilize physician participation and to create an adequate organizational culture.

[Hand surgery in the German DRG System 2007].

Science.gov (United States)

Franz, D; Windolf, J; Kaufmann, M; Siebert, C H; Roeder, N

2007-05-01

Hand surgery often needs only a short length of stay in hospital. Patients' comorbidity is low. Many hand surgery procedures do not need inpatient structures. Up until 2006 special procedures of hand surgery could not be coded. The DRG structure did not separate very complex and less complex operations. Specialized hospitals needed a proper case allocation of their patients within the G-DRG system. The DRG structure concerning hand surgery increased in version 2007 of the G-DRG system. The main parameter of DRG splitting is the complexity of the operation. Furthermore additional criteria such as more than one significant OR procedure, the patients' age, or special diagnoses influence case allocation. A special OPS code for complex cases treated with hand surgery was implemented. The changes in the DRG structure and the implementation of the new OPS code for complex cases establish a strong basis for the identification of different patient costs. Different case allocation leads to different economic impacts on departments of hand surgery. Whether the new OPS code becomes a DRG splitting parameter has to be calculated by the German DRG Institute for further DRG versions.

Internal Migration, Regional Labour Market Dynamics and Implications for German East-West Disparities – Results from a Panel VAR

DEFF Research Database (Denmark)

Alecke, Björn; Mitze, Timo; Untiedt, Gerhard

This paper analyses the causal linkages between regional labour market variables and internal migration flows among German states between 1991–2006. We adopt a Panel VAR approach to identify the feedback effects among the variables and analyse the dynamic properties of the system through impulser......This paper analyses the causal linkages between regional labour market variables and internal migration flows among German states between 1991–2006. We adopt a Panel VAR approach to identify the feedback effects among the variables and analyse the dynamic properties of the system through...... impulseresponse functions.We also use the model to track the evolution of the particular East-West migration since re-unification aiming to shed more light on the East German “empirical puzzle”, characterized by lower migration responses than expected from the regional labour market position relative to the West......:That is, along with a second wave of East-West movements around 2001 net flows out of East Germany were much higher than expected after controlling for its weak labour market and macroeconomic performance. Since this second wave is also accompanied by a gradual fading out of economic distortions...

Influenza Vaccination Rates Among Parents and Health Care Personnel in a German Neonatology Department

Directory of Open Access Journals (Sweden)

Horst Buxmann

2018-01-01

Full Text Available The influenza vaccination is recommended for all German pregnant women and health care personnel (HCP. We are the first to publish vaccination rates of mothers of hospitalized newborns and HCP in neonatal units. Between September 2016 and March 2017, data were collected in our level-III neonatology department in this descriptive multidisciplinary study, using an anonymous questionnaire. As a result, 513 persons were asked to participate, including 330 parents and 183 HCP. We received an 80.3% (412/513 response rate, 87.3% (288/330, and 67.8% (124/183 from parents and HCP, respectively. Ten percent (16/160 of mothers and 4.7% (6/127 of fathers had been vaccinated in 2016–2017 and 54.4% (87/160 mothers and 52.2% (66/127 fathers ever in their lifetime. In 2016–2017, 51.2% (21/41 of physicians had been vaccinated, 25.5% (14/55 of nurses, and 50.0% (14/28 of other staff members. When comparing those who had more than five influenza vaccinations in their life time, physicians were at 43.9% (18/41 versus nurses at 10.9% (6/55 (p < 0.01, and other HCP at 7.4% (2/27 (p < 0.01. The influenza vaccine uptake rate of 10% in mothers of hospitalized neonates is disappointingly low, resulting in 90% of hospitalized neonates being potentially vulnerable to influenza infection at a time where the risk for influenza-related complication can be severe.

Influenza Vaccination Rates Among Parents and Health Care Personnel in a German Neonatology Department.

Science.gov (United States)

Buxmann, Horst; Daun, Anne; Wicker, Sabine; Schlößer, Rolf Lambert

2018-01-05

The influenza vaccination is recommended for all German pregnant women and health care personnel (HCP). We are the first to publish vaccination rates of mothers of hospitalized newborns and HCP in neonatal units. Between September 2016 and March 2017, data were collected in our level-III neonatology department in this descriptive multidisciplinary study, using an anonymous questionnaire. As a result, 513 persons were asked to participate, including 330 parents and 183 HCP. We received an 80.3% (412/513) response rate, 87.3% (288/330), and 67.8% (124/183) from parents and HCP, respectively. Ten percent (16/160) of mothers and 4.7% (6/127) of fathers had been vaccinated in 2016-2017 and 54.4% (87/160) mothers and 52.2% (66/127) fathers ever in their lifetime. In 2016-2017, 51.2% (21/41) of physicians had been vaccinated, 25.5% (14/55) of nurses, and 50.0% (14/28) of other staff members. When comparing those who had more than five influenza vaccinations in their life time, physicians were at 43.9% (18/41) versus nurses at 10.9% (6/55) ( p < 0.01), and other HCP at 7.4% (2/27) ( p < 0.01). The influenza vaccine uptake rate of 10% in mothers of hospitalized neonates is disappointingly low, resulting in 90% of hospitalized neonates being potentially vulnerable to influenza infection at a time where the risk for influenza-related complication can be severe.

The Role of Learning in Health Technology Assessments: An Empirical Assessment of Endovascular Aneurysm Repairs in German Hospitals.

Science.gov (United States)

Varabyova, Yauheniya; Blankart, Carl Rudolf; Schreyögg, Jonas

2017-02-01

Changes in performance due to learning may dynamically influence the results of a technology evaluation through the change in effectiveness and costs. In this study, we estimate the effect of learning using the example of two minimally invasive treatments of abdominal aortic aneurysms: endovascular aneurysm repair (EVAR) and fenestrated EVAR (fEVAR). The analysis is based on the administrative data of over 40,000 patients admitted with unruptured abdominal aortic aneurysm to more than 500 different hospitals over the years 2006 to 2013. We examine two patient outcomes, namely, in-hospital mortality and length of stay using hierarchical regression models with random effects at the hospital level. The estimated models control for patient and hospital characteristics and take learning interdependency between EVAR and fEVAR into account. In case of EVAR, we observe a significant decrease both in the in-hospital mortality and length of stay with experience accumulated at the hospital level; however, the learning curve for fEVAR in both outcomes is effectively flat. To foster the consideration of learning in health technology assessments of medical devices, a general framework for estimating learning effects is derived from the analysis. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd.

Baltic, Slavic, Germanic

Directory of Open Access Journals (Sweden)

Frederik Kortlandt

2017-02-01

Full Text Available The western Indo-European vocabulary in Baltic and Slavic is the result of an Indo-European substratum which contained an older non-Indo-European layer and was part of the Corded Ware horizon. The numbers show that a considerable part of the vocabulary was borrowed after the split between Baltic and Slavic, which came about when their speakers moved westwards north and south of the Pripet marshes. Germanic and Balto-Slavic were never contiguous Indo-European dialects at any stage of their prehistory.

[Cross sectional study of structural quality of German intensive care units. A reevaluation of the DIVI register].

Science.gov (United States)

Fölsch, C; Kofahl, N; Waydhas, C; Stiletto, R

2013-09-01

Effectiveness of intensive care treatment is essential to cope with increasing costs. The German national register of intensive care established by the German Interdisciplinary Association for Intensive Care Medicine (DIVI) contains basic data on the structure of intensive care units in Germany. A repeat analysis of data of the DIVI register within 8 years provides information for the development of intensive care units under different economic circumstances. The recent data on the structure of intensive care units were obtained in 2008 and compared with the primary multicenter study from 2000. The hospitals selected were a representative sample for the whole of Germany. Data on the status of the hospital, staff and technical facilities, foundation of the hospital and the statistics of mechanically ventilated patients were analyzed. The technical facilities and the number of staff have improved from 2000 to 2008. A smaller availability of diagnostic procedures and staff remain in hospitals for basic treatment outside normal working hours. The average utilization of intensive care unit beds was not altered. The existence of intermediate care units did not significantly change the proportion of patients with artificial ventilation or ventilation times. The number of beds in intensive care units was unchanged as was the average number of beds in units and the number of patients treated. A relevant number of beds of intensive care units shifted towards hospitals with private foundation without changes in the overall numbers. The structure of the hospitals was comparable at both time points. The introduction of intermediate care units did not alter ventilation parameters of patients in 2008 compared with 2000. There is no obvious medical reason for the shift of intensive care beds towards private hospitals. The number of staff and patients varied considerably between the intensive care units. The average number of patients treated per bed was not different between the

Smoking restrictions and hospitalization for acute coronary events in Germany

Science.gov (United States)

Sargent, James D.; Demidenko, Eugene; Malenka, David J.; Li, Zhongze; Gohlke, Helmut

2013-01-01

Aims To study the effects of smoking restrictions in Germany on coronary syndromes and their associated costs. Methods and results All German states implemented laws partially restricting smoking in the public and hospitality sectors between August 2007 and July 2008. We conducted a before-and-after study to examine trends for the hospitalization rate for angina pectoris and acute myocardial infarction (AMI) for an insurance cohort of 3,700,384 individuals 30 years and older. Outcome measures were hospitalization rates for coronary syndromes, and hospitalization costs. Mean age of the cohort was 56 years, and two-thirds were female. Some 2.2 and 1.1% persons were hospitalized for angina pectoris and AMI, respectively, during the study period from January 2004 through December 2008. Law implementation was associated with a 13.3% (95% confidence interval 8.2, 18.4) decline in angina pectoris and an 8.6% (5.0, 12.2) decline in AMI after 1 year. Hospitalization costs also decreased significantly for the two conditions—9.6% (2.5, 16.6) for angina pectoris and 20.1% (16.0, 24.2) for AMI at 1 year following law implementation. Assuming the law caused the observed declines, it prevented 1,880 hospitalizations and saved 7.7 million Euros in costs for this cohort during the year following law implementation. Conclusions Partial smoking restrictions in Germany were followed by reductions in hospitalization for angina pectoris and AMI, declines that continued through 1 year following these laws and resulted in substantial cost savings. Strengthening the laws could further reduce morbidity and costs from acute coronary syndromes in Germany. PMID:22350716

German Language Proficiency among Students of Business and Management in the Czech Republic and its Perception: The Importance of German Language Skills on the Labour Market and the Role of Universities in Foreign Language Training

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Zinecker Marek

2014-09-01

Full Text Available This paper presents the results of an empirical study designed to map German language proficiency among students at Czech universities of business and management. The results of this empirical survey can be summarised as follows. First, the ability of students at Czech universities of business and management to communicate in German is poor, and exceeds the general German language proficiency of the Czech population only to an insignificant extent. Second, the school environment (the opportunity to learn the language, compulsory subject, language study motivation has a decisive influence on the respondents’ ability to communicate in German. Third, nearly three-quarters of the respondents perceive German as a language that is very or rather important for their profession and career growth. Fourth, almost two-thirds of the respondents consider the role played by a university of business and management in the improvement of German language proficiency rather or very important. In conclusion, the study proposes directions for the potential development of the national educational system in the area of German language proficiency of university graduates in business and management in the Czech Republic, with an emphasis on the concept of content and language integrated learning (CLIL. We believe that the survey results are also very important from the point of view of enterprises operating in the Czech Republic because of the very close economic relations between the Czech Republic and German-speaking countries.

Regular and problematic leisure-time Internet use in the community: results from a German population-based survey.

Science.gov (United States)

Beutel, Manfred E; Brähler, Elmar; Glaesmer, Heide; Kuss, Daria J; Wölfling, Klaus; Müller, Kai W

2011-05-01

In our study, we attempted to identify systematically the use of Internet applications in the German population in order to derive risk factors for problematic use. In a representative survey of the German population, we queried 1,401 women and 1,111 men between the ages of 14 and 94 years by specific questions and standardized questionnaires on depression, anxiety (HADS), and depersonalization (CDS-2). The majority of the German population (55%) used the Internet in their leisure time. Users were younger and had a higher socioeconomic status (education, employment, income). Leisure-time use included e-mail and information search, as well as shopping. Chatting, online communities, games and sex were domains of young, mostly male adults. Overall, 9.3% reported at least one negative consequence of Internet use, especially neglect of recreational activities and problems with family/partner, work or education, and health. Problematic use was associated with longer average daily online times, avoidance of negative emotions, preference for certain applications (gaming, gambling, online sex) and an increased rate of depersonalization. The extent of Internet use per se is not sufficient as an addiction criterion and other negative consequences; rather, specific adverse consequences need to be identified. If the Internet is used excessively to cope with negative affect states and alternative means of coping (e.g., social support, health-promoting behavior) are diminished, a vicious cycle may ensue with increasing stress and reliance on the reinforcing properties of certain online activities that may finally lead to addictive behavior.

Media Bias and Advertising: Evidence from German Car Magazines

OpenAIRE

Dewenter, Ralf; Heimeshoff, Ulrich

2011-01-01

This paper investigates the existence of a possible media bias by analyzing the impact of automobile manufactures' advertisements on automobile reviews in German car magazines. By accounting for both endogeneity and sample selection we find a positive impact of advertising volumes on test scores. Moreover, also a home bias in terms of higher scores for German cars is observable. We account these results as some evidence for a media bias, induced by the two-sidedness of the markets.

["Lean management" in hospitals: potentials and limitations].

Science.gov (United States)

Glossmann, J P; Schliebusch, O; Diehl, V; Walshe, R

2000-08-15

Little attention has yet been payed on establishing modern and competitive organizational structures in German hospitals. In this paper, we attempt to apply elements of lean management to the work of physicians working in an inpatient setting. Traditional ways of communication and their disadvantages are discussed. These include loss of motivation, bureaucratic structures and a lack of interdisciplinary cooperation. Using Maslow's theory of motivation, possible improvements are discussed, such as the reduction of restrictive job characteristics, an increase of physicians' spheres of competence and the use of their innovative potentials. These suggestions are explained using practical examples. The aim of the study is to contribute to quality management in hospitals by increasing personal responsibilities according to lean management.

USA: German in the Changing Landscape of Postsecondary Education

Science.gov (United States)

Tatlock, Lynne

2010-01-01

This article identifies recent indicators of the state of German Studies in the United States with special attention to postsecondary enrollments in German. It additionally reviews challenges to the postsecondary teaching of German as they manifest themselves both locally and nationally, including the positioning of German Studies in the life of…

Competition effects of mergers: An event study of the German electricity market

International Nuclear Information System (INIS)

Keller, Andreas

2010-01-01

This paper investigates the competition effects of the entry of Vattenfall into the German electricity market. While the competition authorities supported the entry by approving Vattenfall's acquisition of three regional utilities, other market participants raised concerns over the emergence of an upcoming oligopoly in the German market for power generation. We contrast the efficiency hypothesis postulating pro-competitive effects of mergers with the market power hypothesis postulating anti-competitive effects. For the analysis of the two opposing hypotheses, we use an event study approach to the stock prices of Vattenfall's competitors in the German market. While we find no empirical evidence for increased market power in the German electricity market due to Vattenfall's mergers, there is some indication for efficiency increases. We therefore cannot oppose the view of the competition authorities predicting an overall positive effect for consumers as a result of Vattenfall's entry into the German electricity market.

Sport Engagement by Accelerometry under Field Conditions in German Adolescents: Results from GINIPlus.

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Maia Smith

Full Text Available Sporting activities differ in their ability to promote moderate-to-vigorous physical activity (MVPA. To assess adolescents' engagement in sport under field conditions we used accelerometers to measure their MVPA levels during sport. We pay special attention to differences between team and individual sport and between common sports.Diary data and 7-day accelerometry from 1054 Germans ages 15-17 were combined to measure physical activity. 1373 diaried episodes of more than 40 common sports were identified from 626 participants and grouped into team and individual sport. We modeled the effect of team and individual sport, and described levels of MVPA and episodes of no MVPA for all recorded sports.German boys and girls averaged 43 (SD 21 and 37 (SD 24 minutes MVPA per day. Boys got 2.2 times as much MVPA per minute during team compared to individual sport (p<0.0001 but there was no significant difference for girls. Percent of time spent in MVPA during sport ranged from 6% for weight training to 74% for jogging, with individual sports averaging 10-30% and team sports 30-50%. 11% of sport episodes had no MVPA: half of episodes of cycling, 5% of jogging, and none for tennis or badminton. An episode of individual sport was 17 times more likely to have no MVPA than an episode of team sport (p<0.0001.Under field condition, adolescents were active for only a fraction of diaried sporting time. As measured by accelerometry, individual sport often produced no MVPA. Characteristics of the sport, such as team vs. individual, were more predictive of MVPA than were characteristics of the participant, such as background activity levels.

Innovation in tradition. Tönnies Fonne's Russian-German phrasebook (Pskov, 1607)

NARCIS (Netherlands)

Hendriks, Pepijn

2011-01-01

The study explores the history of the language of a manuscript known as Tönnies Fonne’s Russian-German Phrasebook (Pskov 1607). The phrasebook is not, as many scholars have assumed, the result of the efforts of a 19-year-old German merchant, who came to Russia to learn the language and who recorded

Comparison between Dutch and German buildings

Energy Technology Data Exchange (ETDEWEB)

Lony, R.J.M.; Molenaar, D.J.; Rietkerk, J.; Schuiling, D.J.B.W.; Zeiler, W. [TU/e, Univ. of Technology Eindhoven (Netherlands); Brunk, M. [RWTH Aachen (Germany)

2006-07-01

German buildings are often seen as an example to Dutch architects and Dutch building services consultants. Goal of this article is to examine and to understand differences between the Dutch and German top office buildings. Objective is to examine to which extent these buildings were designed intelligently. An Intelligent Building is one that provides a productive cost effective environment through the optimisation of six basic elements; site, skin, systems, structures, services, space plan and staff and the interrelationship between them. Based on these six aspects the comparison is made between Dutch and German buildings. (orig.)

German causative events with placement verbs

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De Knop Sabine

2016-06-01

Full Text Available Several studies have described the semantic uses of German posture verbs, but only few have dealt with German placement verbs. The present study wants to make up for this gap. Starting from a collection of examples from the core corpora of the Digitales Wörterbuch der Deutschen Sprache (DWDS and some former studies on posture verbs, it first describes the variety of the most common German placement verbs stellen (‘to put upright’, legen (‘to lay down’, setzen (‘to set’ and stecken (‘to stick’.

The German-Jewish soldier: from participant to victim.

Science.gov (United States)

Penslar, Derek

2011-01-01

The story of German-Jewish soldiers and veterans of World War I illustrates how, under circumstances of inclusion (even if incomplete) rather than vicious persecution, Jewish suffering in wartime, and with it the forms of collective memory and strategies for commemoration of the dead, could closely parallel, even intersect with, the suffering of Germans as a whole. To be sure, the points of intersection were accompanied by points of deflection. Even when Jews served, fought, suffered and died as German soldiers, their interpretations of the war experience, and their communities’ postwar memory and commemorative practices, differed from those of other Germans. In many ways, however, German-Jewish veterans suffered the aftermath of the war as did other Germans; they shared the prevailing fury over war guilt and reparations, and they retained a strong pride in their military service, a pride through which they interpreted the events of 1933–1945.

Learning from the Germans? History and Memory in German and European Discourses of Integration

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Andrew Beattie

2007-08-01

Full Text Available History and memory appear to be increasingly important to discussions of European values and identity, as exemplified by references to ‘bitter experiences’ and ‘divided pasts’ in the draft EU constitution. The article takes recent suggestions that Europe could learn from German experiences of confronting multiple difficult pasts as its starting point, and considers critically what lessons those German experiences might in fact hold for ‘Europe’. It explores similarities and differences in the two integration contexts and their dominant approaches to, and assumptions about history and public memory. Specifically, it considers debates about the east-west division of the Cold War and about the place of communism and nazism in public memory. Contrary to common assumptions, the article argues that German experiences are not necessarily worth of European emulation.

Classical Music at a German Inner-City School: The German Philharmonic Chamber Orchestra Bremen at Comprehensive School Bremen East

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Anna-Lena Musiol

2013-12-01

Full Text Available The German Philharmonic Chamber Orchestra Bremen, a world famous orchestra for classical music, and the Comprehensive School Bremen East, a school in a deprived area, in North American terms an inner-city school, are cooperating since 2007. A three-year follow-up evaluation study was conducted to find out, if projects facilitated by the presence of the orchestra have a positive impact on the self-reported well-being and the grades of students. Results showed that involvement in the projects distinctly benefited boys: They experience a better class climate and a higher satisfaction with school as well as improved German grades.

GERMANISMS IN THE NORTH ČAKAVIAN DIALECT

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Marija Turk

2005-01-01

Full Text Available This paper deals with Germanisms in some local idioms of the North Čakavian dialect. Phonological, morphological and word-formation variants of Germanisms are identified. Special attention is paid to the semantic fields and to the spatial, temporal, functional and stylistic stratification of the Germanisms, and to the degree to which they are recognized and used by speakers who belong to different generations.

Influences of Discriminatory Incidents on Immigrants’ Attitudes Toward German Society

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Jan Döring

2007-01-01

Full Text Available This article presents findings from a quantitative survey (N = 301 to evaluate the impact discriminatory incidents have on the attitudes of immigrants towards the majority society in Germany.The findings show that there is a strong relationship between experiences of discrimination and a hostile or alienated attitude towards German society. As an attempt to explain this generalization from single incidents to the macro relation between immigrants and autochthonous Germans in general a theory of framing, taken from developments in the field of rational choice theory, is applied. The reasoning is that a generalizing and rather hostile framing in terms of the attitude towards Germans can minimize psychic, emotional and social costs resulting from acts of discrimination.

Online sexual solicitation by adults and peers - Results from a population based German sample.

Science.gov (United States)

Sklenarova, Halina; Schulz, Anja; Schuhmann, Petya; Osterheider, Michael; Neutze, Janina

2018-02-01

Prevalence of Internet use among adolescents is high, but little is known about the online sexual activities of German adolescents. This study aimed to describe the 12-month prevalence of German adolescents' online sexual experiences with a focus on Online Sexual Solicitation (OSS, subjectively negative online sexual experiences with a peer or any sexual online experience, positive or negative, with an adult). A sample of male and female adolescents aged 14-17 (N=2238) was recruited using online survey panel. The sample was representative for gender and education. Subjects completed an online survey reporting their online sexual activities (i.e., sexual conversation, exchanging pictures, and cybersex) with peers (14-17y.) and/or adults (≥18y.). Findings illustrated that 51.3% (n=1148) of adolescents had experienced online sexual activity, which mostly involved peers (n=969; 84.4%). In contrast, 23.2% (n=519) of the adolescents experienced OSS with 2.6% (n=57) reporting subjectively negative online sexual interactions with peers and 22.2% (n=490) reporting online sexual interactions with adults, of which 10.4% (n=51) were perceived as negative. The findings suggest that adolescents frequently engage in sexual interactions on the Internet with only a relatively small number perceiving such contacts as exploitative. In addition, females and adolescents with incomplete family situation, foreign nationality, higher education, homo- or bisexual orientation, and those without perceived social support reported OSS significantly more often. Copyright © 2017 Elsevier Ltd. All rights reserved.

The German risk study for nuclear power plants

International Nuclear Information System (INIS)

Birkhofer, A.

1980-01-01

In August 1979 results of the ''German Risk Study for Nuclear Power Plants'' were published. The Main Report, in which approach and results of the study are documented, has been available since the end of 1979. It was the charter of the study - which was performed on behalf of the Minister of Research and Technology of the Federal Republic of Germany - to apply as far as possible the methods of the US Reactor Safety Study (WASH-1400) to German plant and site conditions. A direct transfer of the results was not deemed justified, mainly for the following reasons: There is quite a number of differences between the design of the reference plants of WASH-1400 (Surry-1, Peach Bottom-2) and German nuclear power plants. The mean population density in the Federal Republic of Germany is more than ten times of the United States. In the vicinity of nuclear power plants the ratio is about 3:1. To calculate the collective risk resulting from reactor accidents, a total of 25 plants at 19 different sites in the Federal Republic of Germany were considered. This included all plants with 600 MW or more electrical output, which were in operation, under construction or in licensing process by July 1, 1977. As an approximation to the real situation, it has been assumed that all 25 plants are technically identical to the reference plant

German atomic low meeting 2004

International Nuclear Information System (INIS)

Ossenbuehl, F.

2005-01-01

The conference report on the German atomic law meeting 2004 contains 14 contributions on the German atomic legislation within four parts: Damage precaution in the operational phase; Legal general requirements for the final disposal - considerations ''de lege lata'' and ''de lege ferenda''. Financing of the site searching by a statutory company (''Verbandsmodell''). Atomic supervision authority - federal executive administration or federal self administration?

Vitamin D Deficiency in Adult Patients with Schizophreniform and Autism Spectrum Syndromes: A One-Year Cohort Study at a German Tertiary Care Hospital

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Dominique Endres

2016-10-01

Full Text Available Introduction: Vitamin D has many immunomodulatory, anti-inflammatory, and neuroprotective functions, and previous studies have demonstrated an association between vitamin D deficiency and neuropsychiatric disease. The aim of our study was to analyze the prevalence of vitamin D deficiency in a one-year cohort of adult inpatients with schizophreniform and autism-spectrum syndromes in a naturalistic in-patient setting in Germany. Participants and methods: Our study was comprised of 60 adult schizophreniform and 23 adult high-functioning autism spectrum patients who were hospitalized Page: 2between January and December of 2015. We compared our findings with a historical German reference cohort of 3,917 adults using Pearson’s two-sided chi-squared test. The laboratory measurements of 25-hydroxyvitamin D2/3 (25(OHvitamin D were obtained using a chemiluminescence immunoassay. Results: In the schizophreniform group, we found decreased ( 30 ng/ml were observed in only 5% of the schizophreniform patients, 8.7% of the autism spectrum patients, and 21.9% of the healthy controls. Discussion: We found very high rates of 25(OHvitamin D deficiency in both patient groups, and have discussed whether our findings might be related to alterations in the immunological mechanisms. Irrespective of the possible pathophysiological links between vitamin D deficiency and schizophrenia or autism spectrum disorders, a more frequent measurement of vitamin D levels seems to be justified in these patient groups. Further prospective, controlled, blinded, and randomized research should be conducted to analyze the effectiveness of vitamin D supplementation on the improvement of psychiatric symptoms.

Immobile Complex Verbs in Germanic

DEFF Research Database (Denmark)

Vikner, Sten

2005-01-01

the V° requirements or the V* requirements. Haider (1993, p. 62) and Koopman (1995), who also discuss such immobile verbs, only account for verbs with two prefix-like parts (e.g., German uraufführen ‘to perform (a play) for the first time' or Dutch herinvoeren ‘to reintroduce'), not for the more...... frequent type with only one prefix-like part (e.g., German bauchreden/Dutch buikspreken ‘to ventriloquize'). This analysis will try to account not only for the data discussed in Haider (1993) and Koopman (1995) but also for the following: - why immobile verbs include verbs with only one prefix-like part...... are immobile, - why such verbs are not found in Germanic VO-languages such as English and Scandinavian....

The German-German history of the nuclear power plant Greifswald. Nuclear power between east and west. 2. ed.

International Nuclear Information System (INIS)

Hoegselius, Per

2015-01-01

The historical study covers the chapters The nuclear power plant Greifswald; Lubmin shortly before the ''Wende'' 1989; the German ''Wende''; from the last vote for the ''Volkskammer (parliament of the German Democratic Republic) to the German reunification; Lubmin in reunified Germany; conclusions and perspectives. In the attachment technical data about the reactors WWER-440/W-230 are summarized, including a list of WWERs in the former eastern bloc countries.

Hospital ownership, decisions on supervisory board characteristics, and financial performance.

Science.gov (United States)

Kuntz, Ludwig; Pulm, Jannis; Wittland, Michael

2016-01-01

Dynamic and complex transformations in the hospital market increase the relevance of good corporate governance. However, hospital performance and the characteristics of supervisory boards differ depending on ownership. The question therefore arises whether hospital owners can influence performance by addressing supervisory board characteristics. The objective of this study is to explain differences in the financial performance of hospitals with regard to ownership by studying the size and composition of supervisory boards. The AMADEUS database was used to collect information on hospital financial performance in 2009 and 2010. Business and quality reports, hospital websites, and data from health insurer were used to obtain information on hospital and board characteristics. The resulting sample consisted of 175 German hospital corporations. We utilized ANOVA and regression analysis to test a mediation hypothesis that investigated whether decisions regarding board size and composition were associated with financial performance and could explain performance differences. Financial performance and board size and composition depend on ownership. An increase in board size and greater politician participation were negatively associated with all five tested measures of financial performance. Furthermore, an increase in physician participation was positively associated with one dimension of financial performance, whereas one negative relationship was identified for nurse and economist participation. For clerics, no associations were found. Decisions concerning board size and composition are important as they relate to hospital financial performance. We contribute to existing research by showing that, in addition to board size and physician participation, the participation of other professionals can also influence financial performance.

[What is the perception of the 10-point plan of the German Federal Ministry of Health against multidrug-resistant pathogens and measures of antibiotic stewardship? : An interdisciplinary analysis among German clinicians and development of a decision tool for urologists].

Science.gov (United States)

May, M; Vetterlein, M W; Wagenlehner, F M; Brookman-May, S D; Gilfrich, C; Fritsche, H-M; Spachmann, P J; Burger, M; Schostak, M; Lebentrau, S

2017-10-01

Due to increasing antibiotic resistances, relevant treatment problems are currently emerging in clinical practice. In March 2015, the German Federal Ministry of Health (BMG) published a 10-point plan designed to combat this development. Furthermore, the first German guideline on antibiotic stewardship (ABS) was implemented in 2013 and instructs physicians of different specialties about several treatment considerations. Evidence is scarce on how such concepts (10-point plan/BMG, ABS) are perceived among clinicians. Within the MR2 study (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria - a survey focusing on German hospitals), a questionnaire including 4 + 35 items was sent to 18 German hospitals between August and October 2015, surveying internists, gynecologists, general surgeons, and urologists. Using multivariate logistic regression models (MLRM), the impact of medical specialty and further criteria on the endpoints (1) awareness of the 10-point plan/BMG and (2) knowledge of ABS measures were assessed. Fulfillment of endpoints was predefined when average or full knowledge was reported (reference: poor to no knowledge). Overall response rate was 43% (456/1061) for fully evaluable questionnaires. Only 63.0 and 53.6% of urologists and nonurologists (internists, gynecologists, and general surgeons), respectively, attended training courses regarding multidrug-resistance or antibiotic prescribing in the 12 months prior to the study (P = 0.045). The endpoints average and full knowledge regarding 10-point plan/BMG and ABS measures were fulfilled in only 31.4 and 32.8%, respectively. In MLRM, clinicians with at least one previous training course (reference: no training course) were 2.5- and 3.8-fold more likely to meet respective endpoint criteria (all P < 0.001). Medical specialty (urologists vs. nonurologists) did not significantly impact the endpoints in both MLRM. The 10-point plan/BMG and ABS programs should be implemented into

Latitudinal Variation of Germane in Jovian Atmosphere

Science.gov (United States)

Hyder, A.; Lunine, J. I.; Wang, D.

2017-12-01

Wang et al (2016) presented a chemical-dynamical model for Jupiter's atmosphere that predicted abundances of Germane and other disequilibrium species as a function of latitude, under the assumption that only vertical transport is relevant and no horizontal advection occurs. The model disagrees with the latitudinal distributions derived from high-resolution spectral data acquired from the CRIRES instrument at the VLT as described in Giles et al. 2017. Wang et al. 2016 predicts a maximum molar abundance of Germane at (0.7±0.2) ppb with depletion at higher latitudes, while Giles et al. 2017 predicts a constant molar abundance of Germane at 0.58 ppb with no depletion. We explore an empirical horizontal term for the diffusive transport coefficient as a function of latitude, which does not produce a satisfactory result unless highly arbitrary variations of the vertical eddy mixing term as a function of latitude are imposed. We therefore also explore a horizontal wind from the equator that produces a constant latitudinal profile by transporting Germane-rich gas to the poles, effectively producing a Hadley cell. References: Giles, R. S., Fletcher, L. N., & Irwin, P. G. (2017). Latitudinal variability in Jupiter's tropospheric disequilibrium species: GeH 4, AsH 3 and PH 3. Icarus, 289, 254-269. Wang, D., Lunine, J.I., Mousis, O., 2016. Modeling the disequilibrium species for Jupiter and Saturn: implications for Juno and Saturn entry probe. Icarus 276, 21-38.

The German radiation protection standards

International Nuclear Information System (INIS)

Becker, Klaus; Neider, Rudolf

1977-01-01

The German Standards Institute (DIN Deutsches Institut fuer Normung, Berlin) is engaged in health physics standards development in the following committees. The Nuclear Standards Committee (NKe), which deals mainly with nuclear science and technology, the fuel cycle, and radiation protection techniques. The Radiology Standards Committee (FNR), whose responsibilities are traditionally the principles of radiation protection and dosimetry, applied medical dosimetry, and medical health physics. The German Electrotechnical Commission (DKE), which is concerned mostly with instrumentation standards. The Material Testing Committee (FNM), which is responsible for radiation protection in nonmedical radiography. The current body of over one hundred standards and draft standards was established to supplement the Federal German radiation protection legislation, because voluntary standards can deal in more detail with the specific practical problems. The number of standards is steadily expanding due to the vigorous efforts of about thirty working groups, consisting of essentially all leading German experts of this field. Work is supported by the industry and the Federal Government. A review of the present status and future plans, and of the international aspects with regard to European and world (ISO, etc.) standards will be presented

Career intentions of female surgeons in German liver transplant centers considering family and lifestyle priorities.

Science.gov (United States)

Radunz, Sonia; Hoyer, Dieter P; Kaiser, Gernot M; Paul, Andreas; Schulze, Maren

2017-02-01

Women represent up to 60 % of students entering the medical profession in many countries in the world. However, the proportion of women to men is not accordingly balanced among surgical residents and especially in leadership positions in surgery. Therefore, we investigated the career goals as well as family and lifestyle priorities of female surgeons in German liver transplant centers. A standardized questionnaire was developed using the web-based survey tool SurveyMonkey®. Questionnaires were distributed electronically to 180 female surgeons in 24 German liver transplant centers. A total of 81 completed questionnaires were analyzed. Female surgeons in German liver transplant centers are eager to assume leadership positions and do not wish to follow traditional role models. After finishing training, most female surgeons plan to continue working at a university hospital. About 80 % of the respondents intend to continue working full time and wish to combine career and family. This is the first survey on career intentions of female surgeons in Germany. In the face of gender changes in the medical profession, we were able to demonstrate that female surgeons are willing to fill leadership positions. Individual and institutional creative modifications are necessary if the advancement of women in surgery is to be promoted.

Assessing hospitals' clinical risk management: Development of a monitoring instrument

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Pfeiffer Yvonne

2010-12-01

Full Text Available Abstract Background Clinical risk management (CRM plays a crucial role in enabling hospitals to identify, contain, and manage risks related to patient safety. So far, no instruments are available to measure and monitor the level of implementation of CRM. Therefore, our objective was to develop an instrument for assessing CRM in hospitals. Methods The instrument was developed based on a literature review, which identified key elements of CRM. These elements were then discussed with a panel of patient safety experts. A theoretical model was used to describe the level to which CRM elements have been implemented within the organization. Interviews with CRM practitioners and a pilot evaluation were conducted to revise the instrument. The first nationwide application of the instrument (138 participating Swiss hospitals was complemented by in-depth interviews with 25 CRM practitioners in selected hospitals, for validation purposes. Results The monitoring instrument consists of 28 main questions organized in three sections: 1 Implementation and organizational integration of CRM, 2 Strategic objectives and operational implementation of CRM at hospital level, and 3 Overview of CRM in different services. The instrument is available in four languages (English, German, French, and Italian. It allows hospitals to gather comprehensive and systematic data on their CRM practice and to identify areas for further improvement. Conclusions We have developed an instrument for assessing development stages of CRM in hospitals that should be feasible for a continuous monitoring of developments in this important area of patient safety.

The paradox of falling job satisfaction with rising job stickiness in the German nursing workforce between 1990 and 2013.

Science.gov (United States)

Alameddine, Mohamad; Bauer, Jan Michael; Richter, Martin; Sousa-Poza, Alfonso

2017-08-29

Literature reports a direct relation between nurses' job satisfaction and their job retention (stickiness). The proper planning and management of the nursing labor market necessitates the understanding of job satisfaction and retention trends. The objectives of the study are to identify trends in, and the interrelation between, the job satisfaction and job stickiness of German nurses in the 1990-2013 period using a flexible specification for job satisfaction that includes different time periods and to also identify the main determinants of nurse job stickiness in Germany and test whether these determinants have changed over the last two decades. The development of job stickiness in Germany is depicted by a subset of data from the German Socio-Economic Panel (1990-2013), with each survey respondent assigned a unique identifier used to calculate the year-to-year transition probability of remaining in the current position. The changing association between job satisfaction and job stickiness is measured using job satisfaction data and multivariate regressions assessing whether certain job stickiness determinants have changed over the study period. Between 1990 and 2013, the job stickiness of German nurses increased from 83 to 91%, while their job satisfaction underwent a steady and gradual decline, dropping by 7.5%. We attribute this paradoxical result to the changing association between job satisfaction and job stickiness; that is, for a given level of job (dis)satisfaction, nurses show a higher stickiness rate in more recent years than in the past, which might be partially explained by the rise in part-time employment during this period. The main determinants of stickiness, whose importance has not changed in the past two decades, are wages, tenure, personal health, and household structure. The paradoxical relation between job satisfaction and job stickiness in the German nursing context could be explained by historical downsizing trends in hospitals, an East

German Grammar in the Students' Words: The "Essentialization" of German Grammar by American College-Level Learners

Science.gov (United States)

Chavez, Monika

2011-01-01

This study of 134 college-level learners of German, enrolled in four years of instruction, showed them to "essentialize" German grammar when asked to describe it to a hypothetical friend. Kubota defined the term essentialization to capture learners' views of the target culture. Its main characteristic is the presupposition of "essential, stable,…

Medical work Assessment in German hospitals: a Real-time Observation study (MAGRO – the study protocol

Directory of Open Access Journals (Sweden)

Mache Stefanie

2009-06-01

Full Text Available Abstract Background The increasing economic pressure characterizes the current situation in health care and the need to justify medical decisions and organizational processes due to limited financial resources is omnipresent. Physicians tend to interpret this development as a decimation of their own medical influence. This becomes even more obvious after a change in hospital ownership i.e. from a public to a private profit oriented organization. In this case each work procedure is revised. To date, most research studies have focused mainly on differences between hospitals of different ownership regarding financial outcomes and quality of care, leaving important organizational issues unexplored. Little attention has been devoted to the effects of hospital ownership on physicians' working routines. The aim of this observational real time study is to deliver exact data about physicians' work at hospitals of different ownership. Methods The consequences of different management types on the organizational structures of the physicians' work situation and on job satisfaction in the ward situation are monitored by objective real time studies and multi-level psycho diagnostic measurements. Discussion This study is unique in its focus. To date no results have been found for computer-based real time studies on work activity in the clinical field in order to objectively evaluate a physician's work-related stress. After a complete documentation of the physicians' work processes the daily work flow can be estimated and systematically optimized. This can stimulate an overall improvement of health care services in Germany.

Reforms in German Higher Education: Implementing and Adapting Anglo-American Organizational and Management Structures at German Universities

Science.gov (United States)

Liefner, Ingo; Schatzl, Ludwig; Schroder, Thomas

2004-01-01

Currently, the German higher education system is undergoing drastic reform. Competitive structures and funding mechanisms are being introduced that are already successfully used in other countries. However, critics state that cultural differences prevent the effective application, in German universities, of funding mechanisms and incentives…

'Controllable dose'. Results and proposals from discussions within the German-Swiss radiation protection association (FS)

International Nuclear Information System (INIS)

Brunner, H.H.

2000-01-01

The FS has translated the proposal by Roger Clarke into German and has published it both on its webpage and in its journal 'Strahlenschutz PRAXIS' 2/99 interesting discussions have taken place among members, within the Board and within Working Groups, and a workshop is planned for early 2000. Results of these discussions and some recommendations and suggestions for the development of the proposal will be presented. The spread of opinions is shown, but no attempt is yet made to develop a formal opinion or position of the FS on this matter. The FS is ready to co-operate in the further development of this topic and will deal with it also in its coming annual congresses. A fundamental question is, whether the new concept can become a mere addition to the existing concepts and recommendations, or whether ICRP will have to reconsider and renew the entire concept and fundamentals of radiation protection. One consequence might be to go all the way and stop to base the 'limits' on risk considerations. Risk as a term and as a concept is mostly misunderstood and misused. The new concept should not simply add a new quantity and unit to the too many already existing ones but reduce the number or quantities to the indispensable ones for application. Another problem which ICRP will have to manage in future recommendations independently of the fate of the Clarke proposal is to provide unequivocal and equivalent translations of any special terminology into the major languages (German, French, Spanish, Russian, Japanese, Chinese). Abolishing collective dose is welcomed. For special purposes such as comparing the radiation protection efficiency of specific tasks, the sum of individual doses should rather be called 'group dose' or 'team dose'. The coming discussions will also have to include proposals and guidance on how to implement a new or revised concept and how to make the transition to it. Therefore, once ICRP will have decided to proceed, a first draft of new Basic Safety

A German format for pupils’ training

CERN Multimedia

Antonella Del Rosso

2012-01-01

Every year CERN welcomes thousands of pupils from schools worldwide for a half-day visit to the Laboratory. However, since 2011 about ten selected students from Germany have been given the opportunity to experience CERN in much greater depth. They are fully sponsored by the German Ministry of Education and supported by an organising structure at TU Dresden - the Dresden University of Technology - led by Michael Kobel. It’s an investment that's paying off in Germany.   The German teachers who participated in the “Netzwerk Teilchenwelt” project, at CERN last week. “Netzwerk Teilchenwelt” is a project that involves 23 German universities, the DESY Laboratory, several schools and, of course, CERN. Launched in 2010 with a contribution from the German Ministry for Science and Research of about 1 million euros over three years, the project has so far involved over 4,000 students and 500 teachers. “Thanks to this project, both pupils...

THE INSTITUTIONAL BASIS OF GERMAN-BRAZILIAN COMMUNITIES (PICADAS: THE COMMONS AND SOCIAL CAPITAL

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Eduardo Relly

2015-05-01

Full Text Available The historiography of German immigration to Brazil knows just a little about the structures that animated social life in Germany before the process of immigration. Therefore, the americanização of the German-Brazilian settlers is considered solely from the perspective of the host society, creating a gap that needs to be filled in order to understand another dimension of German immigration, the European side and influence over it. In this sense, it is possible to perceive that generally the social origins of German-Brazilian settlers is linked to a village context experience, especially those who came from Western and Southwestern Germany. Historically these villages were social organizations able to control natural and economic resources under their jurisdictions with a great political and economic autonomy. The so called commons were a feature of the German agrarian history, and its institutions of participatory, mutual, protectionist, communal management had the effect to generate social capital, one social attribute that supported the formation of the German-Brazilian communities in Southern Brazil. Thus, the German-Brazilian communities were forged under a solid institutional tradition and under a substrate of social capital, facilitating the emergence of autonomous and cooperative behaviors that resulted on the communitarian structures and on the associativism phenomenon. The method was the analytical descriptive based on research in primary sources in Brazilian and German Archives.

A magnetotelluric profile across the German Deep Drilling Project (KTB) area: Two- and three-dimensional modeling results

Czech Academy of Sciences Publication Activity Database

Eisel, M.; Haak, V.; Pek, Josef; Červ, Václav

2001-01-01

Roč. 106, B8 (2001), s. 16061-16073 ISSN 0148-0227 R&D Projects: GA ČR GA205/99/0917 Institutional research plan: CEZ:AV0Z3012916 Keywords : magnetotelluric profile * KTB * German Deep Drilling Project Subject RIV: DE - Earth Magnetism, Geodesy, Geography Impact factor: 2.609, year: 2001

Mortality of German travellers on passenger vessels.

Science.gov (United States)

Oldenburg, Marcus; Herzog, Jan; Püschel, Klaus; Harth, Volker

2016-01-01

In the past two decades, more and more Germans decided to spend their holidays on a passenger vessel. This study examined the frequencies and causes of deaths of German travellers aboard passenger vessels of all flags. The shipboard deaths of all German travellers within the time period from 1998 to 2008 were counted using the German civil central register in Berlin. The available documentation in this register provides information on frequencies, circumstances and causes of deaths on ships. In the above-mentioned period of time, the total cohort of German travellers on cruise ships is estimated to be 5.97 million persons. During the 11-year examination period, 135 shipboard deaths of German passengers [102 males (75.6%) and 33 females (24.4%)] were recorded. Out of these travellers, 110 died on cruise ships. When considering only the passengers on cruise ships (without those on ferries) an average crude mortality rate of 1.8 per 100,000 German passengers was calculated. The crude mortality rate of shipboard death for males and females was 2.5 and 0.8 per 100,000 German passengers with a mean age of 71.2 years [standard deviation (SD) 16.0 years] and 73.3 years (SD 16.0 years), respectively. Significantly, more deceased travellers older than 70 years were observed on traditional cruise ships and resort vessels than on passenger ferries (P = 0.001). The causes of death were documented in 85 cases (63.0%). Out of these documented deaths, 82 (96.5%) cases were regarded to be natural causes (particularly circulatory diseases) and 3 (3.5%) as unnatural causes (twice drowning and once an accidental fall). In spite of the large proportion of unknown causes of death, this study argues for a high significance of internal causes of deaths among German passengers. Thus, ship's doctors-particularly those on traditional cruise ships-should be well experienced in internal and geriatric medicines. © The Author 2016. Published by Oxford University Press on behalf of

Skin care practice in German nursing homes: a German-wide cross-sectional study.

Science.gov (United States)

Kottner, Jan; Rahn, Yasmin; Blume-Peytavi, Ulrike; Lahmann, Nils

2013-04-01

Due to anatomical and physiological changes in the course of aging and due to increased vulnerability, there are special skin care needs in elderly and care-dependent persons. Little is known about skin care practice in German long-term care facilities. The aim of the study was to gather epidemiological data about skin care practice in German nursing homes. In spring 2012 a German-wide cross sectional study was conducted in 47 nursing homes. Based on standardized data collection sheets. demographics and variables about methods and frequencies of skin cleansing and application of skin care products for 3 552 nursing home residents were collected and analyzed. The variables age, gender and level of care dependency was representative for the group of all German nursing home residents. More than 90% of investigated nursing home residents required skin care assistance. Washing body parts or the whole body were conducted most frequently (89.1%, 95% CI 88.0- 90.1). Skin care leave-on products were used in 91.7% (95% CI 90.7-92.6), whereas there were large variations between individuals. In total, more than 100 brands were used. Skin care practice in multimorbid care dependent persons shows large variations. How skin care products meet the special requirements of aged skin and whether they enhance the skin barrier function and prevent cuteneous skin damage is unknown. © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

Psychosocial working conditions and well-being among immigrant and German low-wage workers.

Science.gov (United States)

Hoppe, Annekatrin

2011-04-01

Despite a steady increase of immigrant workers in Germany in the past decades, occupational health research has only peripherally addressed psychosocial working conditions and immigrant worker well-being. This study has two aims: (1) to investigate differences in psychosocial stressors and resources between immigrant and German low-wage workers, and (2) to examine group differences in their association with well-being using a structural equation modeling multiple group analysis approach. Eighty-nine immigrant and 146 German postmen of a German mail service company were surveyed. Results reveal more stressors in the social work environment for the immigrant workers than for their German coworkers but similar levels of task-related stressors in both groups. Stressors are more strongly associated with psychological distress among the German workers. In terms of resources, job control serves as a resource only among German workers, whereas supervisor and coworker support are more important for immigrant workers. These differences suggest that cultural factors, previous work experiences, and expectations influence the worker's experience of psychosocial working conditions and have a direct impact on worker health.

Sustainable Civil-Society Engagement: Potentials of a Transnational Civil Society in French-German, Polish-German, and Czech-German Border Regions

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Klaus Boehnke

2015-04-01

Full Text Available Based on representative survey data, the present study examines potentials for the sustainable development of a transnational civil society in French-German, Polish-German, and Czech-German border regions. The theoretical framework is a social capital approach in the tradition of Putnam. Transnational engagement is seen as a key element for the development of a border-crossing civil society. For the analysis, existing forms of social capital were classified according to their bridging and bonding functions and the potentials of local and transnational activities are described. Furthermore, using multilevel analysis, the predictive power of different variables like individual dispositions and specific contexts of the regions on cross-border activities are examined. Descriptively, the expected lower level of local civil-society engagement, in general, and also with regard to the transnational activities was found for post-socialist border regions. It is shown that, first and foremost, existing experience in civil-society engagement in the local context is a high-impact predictor for both transnational activities and an interest in such activities. Other variables like feelings of a historical burden or the economic situation of the region are less important.

Antecedents of CIOs' Innovation Capability in Hospitals: Results of an Empirical Study.

Science.gov (United States)

Liebe, Jan-David; Esdar, Moritz; Thye, Johannes; Hübner, Ursula

2017-01-01

CIOs' innovation capability is regarded as a precondition of successful HIT adoption in hospitals. Based on the data of 142 CIOs, this study aimed at identifying antecedents of perceived innovation capability. Eight features describing the status quo of the hospital IT management (e.g. use of IT governance frameworks), four features of the hospital structure (e.g. functional diversification) and four CIO characteristics (e.g. duration of employment) were tested as potential antecedents in an exploratory stepwise regression approach. Perceived innovation capability in its entirety and its three sub-dimensions served as criterion. The results show that CIOs' perceived innovation capability could be explained significantly (R2=0.34) and exclusively by facts that described the degree of formalism and structure of IT management in a hospital, e.g. intensive and formalised strategic communication, the existence of an IT strategy and the use of IT governance frameworks. Breaking down innovation capability into its constituents revealed that "innovative organisational culture" contributed to a large extent (R2=0.26) to the overall result sharing several predictors. In contrast, "intrapreneurial personality" (R2=0.11) and "openness towards users" (R2=0.18) could be predicted less well. These results hint at the relationship between working in a well-structured, formalised and strategy oriented environment and the overall feeling of being capable to promote IT innovation.

The Dividend Policy of German Firms

NARCIS (Netherlands)

Andres, C.; Betzer, A.; Goergen, M.; Renneboog, L.D.R.

2008-01-01

Abstract: German firms pay out a lower proportion of their cash flows, but a higher proportion of their published profits than UK and US firms. We estimate partial adjustment models and report two major findings. First, German firms base their dividend decisions on cash flows rather than published

The Dividend Policy of German Firms

NARCIS (Netherlands)

Andres, C.; Betzer, A.; Goergen, M.; Renneboog, L.D.R.

2008-01-01

German firms pay out a lower proportion of their cash flows, but a higher proportion of their published profits than UK and US firms. We estimate partial adjustment models and report two major findings. First, German firms base their dividend decisions on cash flows rather than published earnings as

A hospital-randomized controlled trial of a formal quality improvement educational program in rural and small community Texas hospitals: one year results.

Science.gov (United States)

Filardo, Giovanni; Nicewander, David; Herrin, Jeph; Edwards, Janine; Galimbertti, Percy; Tietze, Mari; McBride, Susan; Gunderson, Julie; Collinsworth, Ashley; Haydar, Ziad; Williams, Josie; Ballard, David J

2009-08-01

To investigate the effectiveness of a quality improvement educational program in rural hospitals. Hospital-randomized controlled trial. A total of 47 rural and small community hospitals in Texas that had previously received a web-based benchmarking and case-review tool. The 47 hospitals were randomized either to receive formal quality improvement educational program or to a control group. The educational program consisted of two 2-day didactic sessions on continuous quality improvement techniques, followed by the design, implementation and reporting of a local quality improvement project, with monthly coaching conference calls and annual follow-up conclaves. Performance on core measures for community-acquired pneumonia and congestive heart failure were compared between study groups to evaluate the impact of the educational program. No significant differences were observed between the study groups on any measures. Of the 23 hospitals in the intervention group, only 16 completed the didactic program and 6 the full training program. Similar results were obtained when these groups were compared with the control group. While the observed results suggest no incremental benefit of the quality improvement educational program following implementation of a web-based benchmarking and case-review tool in rural hospitals, given the small number of hospitals that completed the program, it is not conclusive that such programs are ineffective. Further research incorporating supporting infrastructure, such as physician champions, financial incentives and greater involvement of senior leadership, is needed to assess the value of quality improvement educational programs in rural hospitals.

The Origin of German-American Relations as a Partnership of Unequal Parties

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Egor S. Leonov

2015-01-01

Full Text Available Abstract: Despite the high technological effectiveness of today’s German economy which serves as the «engine» of Europe and the core of the European integration processes, Germany, however, possesses a limited foreign policy leverage in the modern international relations. Gradual restriction of the sovereignty of Germany began during the post-war period due to the strengthening of the European track of U.S. foreign policy. For instance, at this stage Washington takes the responsibility on restoration of the German economic welfare, filling of legal vacuum in West Germany and also initiates cultural and ideological expansion. In the latter case it was an important role played by the American course on the formation of the renewed German nation by means of work with the German youth and the control over the sphere of education. In fact, at the end of the war US authorities started in West Germany experimental project from scratch, since there were no state institutions in postwar Germany in principle. At the same time, German foreign policy takes shape in the 1950s in the spirit of «Atlantic solidarity» as a result of falling into the trap of Euro-Atlantic partnership. Hopes of attainment of foreign policy independence as a result of German reunification did not come true - the United States haven’t yet set Germany free from the sphere of its geopolitical influence. American military forces with nuclear component continue to be based within the territory of Germany. In addition, in the 1990s. Germany finds itself in even deeper trade, investment and financial bondage. The article analyzes the origin of German full-scale dependence on U.S. foreign policy.

The Jewish psychiatric hospital, Zofiówka, in Otwock, Poland.

Science.gov (United States)

Seeman, Mary V

2015-03-01

The T4 euthanasia programme within Nazi Germany has been well researched, but much less is known about the extermination of psychiatric patients in Nazi-occupied territories during the same period. In Poland 20,000 mentally ill patients were deliberately killed during the German occupation. This paper traces the history of one psychiatric hospital, Zofiówka, in Otwock, south-east of Warsaw. The hospital once served the Jewish population of Poland and was the largest, most prestigious neuropsychiatric centre in the country. It is now in ruins and said to be haunted by ghosts. © The Author(s) 2014.

Fifty years of German nuclear legislation

International Nuclear Information System (INIS)

Heller, W.

2006-01-01

The political situation and the state of legislation after World War II make it difficult to pinpoint a precise date of origin of German nuclear legislation. The restrictions imposed by the Allied High Commission (AHC) without any exception put a ban on the production of uranium and thorium metal as well as the construction of nuclear reactors. These restrictions were lifted expressly when the German Atomic Energy Act (AtG) entered into force on January 1, 1960, i.e. much later than the formal step of gaining sovereignty, which was marked by the protocol of May 5, 1955 terminating the Occupation Statute. In October 1955, the German federal government established the then Federal Ministry for Atomic Matters also in an attempt to reconnect to developments in nuclear fission in other parts of the Western world. To supersede the AHC law, the German federal government in December 1956 publicized a draft Atomic Energy Act. It is safe, therefore, to consider that year the starting point of German atomic legislation. This step was followed by deliberations preparatory to the adoption of the Atomic Energy Act. In 1957, however, adoption failed because no two-thirds majority was reached to amend the Basic Law, i.e. the Constitution. As a consequence, some federal states saw the need to adopt state legislation to regulate this area. On December 3, 1959, a new draft Atomic Energy Act was adopted by the German federal parliament after the second and third readings - coupled with an amendment to the Basic Law on that same day - with the votes of the opposition and with one abstention. (orig.)

Endangering of Businesses by the German Inheritance Tax? – An Empirical Analysis

Directory of Open Access Journals (Sweden)

Henriette Houben

2011-04-01

Full Text Available This contribution addresses the substantial tax privilege for businesses introduced by the German Inheritance Tax Act 2009. Advocates of the vast or even entire tax exemption for businesses stress the potential damage of the inheritance tax on businesses, as those often lack liquidity to meet tax liability. This submission tackles this issue empirically based on data of the German Inheritance Tax Statistics and the SOEP. The results indicate that former German inheritance tax law has not endangered transferred businesses. Hence, there is no need for the tremendous tax privilege for businesses in current German inheritance tax law. An alternative flat inheritance tax without tax privileges, which meets revenue neutrality per tax class according to current tax law, provokes in some cases relative high tax loads which might trouble businesses.

Abortion checks at German-Dutch border.

Science.gov (United States)

Von Baross, J

1991-05-01

The commentary on West German abortion law, particularly in illegal abortion in the Netherlands, finds the law restrictive and in violation of the dignity and rights of women. The Max-Planck Institute in 1990 published a study that found that a main point of prosecution between 1976 and 1986, as reported by Der Spiegal, was in border crossings from the Netherlands. It is estimated that 10,000 annually have abortions abroad, and 6,000 to 7,000 in the Netherlands. The procedure was for an official to stop a young person and query about drugs; later the woman would admit to an abortion, and be forced into a medical examination. The German Penal Code Section 218 stipulates abortion only for certain reasons testified to by a doctor other than the one performing the abortion. Counseling on available social assistance must be completed 3 days prior to the abortion. Many counseling offices are church related and opposed to abortions. Many doctors refuse legally to certify, and access to abortion is limited. The required hospital stay is 3-4 nights with no day care facilities. Penal Code Section 5 No. 9 allows prosecution for uncounseled illegal abortion. Abortion law reform is anticipated by the end of 1992 in the Bundestag due to the Treaty or the Unification of Germany. The Treaty states that the rights of the unborn child must be protected and that pregnant women relieve their distress in a way compatible with the Constitution, but improved over legal regulations from either West or East Germany, which permits abortion on request within 12 weeks of conception without counseling. It is hoped that the law will be liberalized and Penal Code Section 5 No. 9 will be abolished.

Comparative population genetics of the German shepherd dog in South Africa

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N. J. Coutts

2010-01-01

Full Text Available Modern breeding practices strive to achieve distinctive phenotypic uniformity in breeds of dogs, but these strategies are associated with the inevitable loss of genetic diversity. Thus, in parallel with the morphological variation displayed by breeds, purebred dogs commonly express genetic defects as a result of the inbreeding associated with artificial selection and the reduction of selection against disease phenotypes. Microsatellite marker analyses of 15 polymorphic canine loci were used to investigate measures of genetic diversity and population differentiation within and between German-bred and South African-bred German shepherd dogs. These data were quantified by comparison with typically outbred mongrel or crossbred dogs. Both the imported and locally-bred German shepherd dogs exhibited similar levels of genetic diversity. The breed is characterised by only a moderate loss of genetic diversity relative to outbred dogs, despite originating from a single founding sire and experiencing extensive levels of inbreeding throughout the history of the breed. Non-significant population differentiation between the ancestral German and derived South African populations indicates sufficient contemporary gene flow between these populations, suggesting that migration resulting from the importation of breeding stock has mitigated the effects of random genetic drift and a population bottleneck caused by the original founder event in South Africa. Significant differentiation between the combined German shepherd dog population and the outbred dogs illustrates the effects of selection and genetic drift on the breed since its establishment just over 100 years ago.

Thresholds of probable problematic gambling involvement for the German population: Results of the Pathological Gambling and Epidemiology (PAGE) Study.

Science.gov (United States)

Brosowski, Tim; Hayer, Tobias; Meyer, Gerhard; Rumpf, Hans-Jürgen; John, Ulrich; Bischof, Anja; Meyer, Christian

2015-09-01

Consumption measures in gambling research may help to establish thresholds of low-risk gambling as 1 part of evidence-based responsible gambling strategies. The aim of this study is to replicate existing Canadian thresholds of probable low-risk gambling (Currie et al., 2006) in a representative dataset of German gambling behavior (Pathological Gambling and Epidemiology [PAGE]; N = 15,023). Receiver-operating characteristic curves applied in a training dataset (60%) extracted robust thresholds of low-risk gambling across 4 nonexclusive definitions of gambling problems (1 + to 4 + Diagnostic and Statistical Manual for Mental Disorders-Fifth Edition [DSM-5] Composite International Diagnostic Interview [CIDI] symptoms), different indicators of gambling involvement (across all game types; form-specific) and different timeframes (lifetime; last year). Logistic regressions applied in a test dataset (40%) to cross-validate the heuristics of probable low-risk gambling incorporated confounding covariates (age, gender, education, migration, and unemployment) and confirmed the strong concurrent validity of the thresholds. Moreover, it was possible to establish robust form-specific thresholds of low-risk gambling (only for gaming machines and poker). Possible implications for early detection of problem gamblers in offline or online environments are discussed. Results substantiate international knowledge about problem gambling prevention and contribute to a German discussion about empirically based guidelines of low-risk gambling. (c) 2015 APA, all rights reserved).

Operational Art and the German 1918 Offensives

OpenAIRE

Zabecki, D T

2009-01-01

At the tactical level of war the Germans are widely regarded as having had the most innovative and proficient army of World War I. Likewise, many historians would agree that the Germans suffered from serious, if not fatal, shortcomings at the strategic level of war. It is at the middle level of warfare, the operational level, that the Germans seem to be the most difficult to evaluate. Although the operational was only fully accepted in the 1980s by many Western militaries as...

Reciprocity in Intergenerational Support: A Comparison of Chinese and German Adult Daughters

Science.gov (United States)

Schwarz, Beate; Trommsdorff, Gisela; Zheng, Gang; Shi, Shaohua

2010-01-01

This study investigates how Chinese and German adult daughters evaluate the norm of reciprocity and the unbalanced exchange of support in relation to their aging parents. Women from rural and urban China (n = 292) and from Germany (n = 264) have participated in this study. Results show that for the German daughters, differently from rural Chinese…

High-Speed Maglev Trains; German Safety Requirements

Science.gov (United States)

1991-12-31

This document is a translation of technology-specific safety requirements developed : for the German Transrapid Maglev technology. These requirements were developed by a : working group composed of representatives of German Federal Railways (DB), Tes...

The Danish Press during the German Occupation

DEFF Research Database (Denmark)

Roslyng-Jensen, Palle

2010-01-01

Censorship, self-censorship in Danish newspapers and Danish Radio during the German occupation of Denmark 1940-45......Censorship, self-censorship in Danish newspapers and Danish Radio during the German occupation of Denmark 1940-45...

The perception of the fehmarnbelt connection among german stakeholders

DEFF Research Database (Denmark)

Lohse, Sandrina; Jespersen, Per Homann

This report gives an overview of the planned improvements of the German hinterland infrastructure connected to the fixed Fehmarn Belt Link (FBL), as well as the views of the key German stake holders towards the FBL.......This report gives an overview of the planned improvements of the German hinterland infrastructure connected to the fixed Fehmarn Belt Link (FBL), as well as the views of the key German stake holders towards the FBL....

Psychometric properties and measurement invariance of the Beck hopelessness scale (BHS): results from a German representative population sample.

Science.gov (United States)

Kliem, Sören; Lohmann, Anna; Mößle, Thomas; Brähler, Elmar

2018-04-25

The Beck Hopelessness Scale (BHS) has been the most frequently used instrument for the measurement of hopelessness in the past 40 years. Only recently has it officially been translated into German. The psychometric properties and factor structure of the BHS have been cause for intensive debate in the past. Based on a representative sample of the German population (N = 2450) item analysis including item sensitivity, item-total correlation and item difficulty was performed. Confirmatory factor analyses (CFA) for several factor solutions from the literature were performed. Multiple group factor analysis was performed to assess measurement invariance. Construct validity was assessed via the replication of well-established correlations with concurrently assessed measures. Most items exhibited adequate properties. Items #4, #8 and #13 exhibited poor item characteristics- each of these items had previously received negative evaluations in international studies. A one-dimensional factor solution, favorable for the calculation and interpretation of a sum score, was regarded as adequate. A bi-factor model with one content factor and two method factors (defined by positive/negative item coding) resulted in an excellent model fit. Cronbach's alpha in the current sample was .87. Hopelessness, as measured by the BHS, significantly correlated in the expected direction with suicidal ideation (r = .36), depression (r = .53) and life satisfaction (r = -.53). Strict measurement invariance could be established regarding gender and depression status. Due to limited research regarding the interpretation of fit indices with dichotomous data, interpretation of CFA results needs to remain tentative. The BHS is a valid measure of hopelessness in various subgroups of the general population. Future research could aim at replicating these findings using item response theory and cross-cultural samples. A one-dimensional bi-factor model seems appropriate even in a non

Teaching German Culture: An Alternative Approach.

Science.gov (United States)

Ray, Maruta L.

1985-01-01

Describes a college course on German culture in which the criterion for the inclusion of any topic in the syllabus is its mention--preferably recurrent--in the German press. Additional emphasis is placed upon the historical background of the current events. Classes are a combination of films, lectures, discussions, and student reports. (SED)

Improving Critical Thinking and Authenticity in Testing Business German

DEFF Research Database (Denmark)

Egbert, Maria; Maxim, Hiram

1998-01-01

in Business German, the Priifung Wirtschaftsdmtsch Intmnational [International Business German Examination] (PWD) and the Zertijikat I)mtschfur den Bmuf [German Cer- tificate for Professional Purposes] (ZDfB), test only students' information retrieval skills and fail to assess their critical thinking...

Antibiotic Conformity with Culture Results of Hospitalized Pneumonia Patients in Melati Ward at Dr. Hasan Sadikin General Hospital Bandung, Indonesia

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Randhi Rinaldi

2016-12-01

Full Text Available Background: Pneumonia is an infection with the highest mortality rate in Indonesian hospitals. According to The American Thoracic Society and The Infectious Diseases Society of America (ATS/IDSA, empirical use of antibiotics is still effective for pneumonia treatment. Inappropriate use of antibiotics would cause negative effects such as prolonged hospitalization, a high cost of treatment, and increased antibiotic-resistant bacteria. The goal of this study was to clarify the empirical use of antibiotic conformity with a bacteria culture. Methods: This study was conducted from August to October 2013 using a descriptive retrospective method based on 116 medical records of pneumonia patients hospitalized in Melati Ward, Dr. Hasan Sadikin General Hospital Bandung during 2011–2012. The type of bacteria, conformity with antibiotics given to patients, and type of antibiotics were analyzed. The conformity of antibiotics was assessed based on the resistance test. If the results were sensitive, they would be put in the conforming group and in the non-conforming group if the results were resistant or intermediate. Data was derived with descriptive statistics, using percentage and frequency distribution, illustrated in tables and figures. Results: Based on culture results and sensitivity of antibiotic empirical therapy given, 55.17% cases were conformed. The most widely used antibiotic group was Third-generation Cephalosporin (60.34%. The most common bacterias were Klebsiella pneumonia (34.5% and Acinetobacter baumanni (13.8%. Conclusions: Most of the antibiotics given to pneumonia patients are still appropriate with results of the bacteria culture test and resistance test.

Composition and microstructure of zirconium and hafnium germanates obtained by different chemical routes

International Nuclear Information System (INIS)

Utkin, A.V.; Prokip, V.E.; Baklanova, N.I.

2014-01-01

The phase composition and morphology of zirconium and hafnium germanates synthesized by ceramic and co-precipitation routes were studied. The products were characterized using high-temperature X-ray diffraction analysis (XRD), Raman spectroscopy, scanning electron microscopy (SEM) and thermal (TG/DTA) analysis. To investigate the phase composition and stoichiometry of compounds the unit cell parameters were refined by full-profile Rietveld XRD analysis. The morphology of products and its evolution during high-temperature treatment was examined by SEM analysis. It was stated that there is the strong dependence of the phase composition and morphology of products on the preparation route. The ceramic route requires a multi-stage high-temperature treatment to obtain zirconium and hafnium germanates of 95% purity or more. Also, there are strong diffusion limitations to obtain hafnium germanate Hf 3 GeO 8 by ceramic route. On the contrary, the co-precipitation route leads to the formation of nanocrystalline single phase germanates of stoichiometric composition at a relatively low temperatures (less than 1000 °C). The results of quantitative XRD analysis showed the hafnium germanates are stoichiometric compounds in contrast to zirconium germanates that form a set of solid solutions. This distinction may be related to the difference in the ion radii of Zr and Hf. - Graphical abstract: The phase composition and morphology of zirconium and hafnium germanates synthesized by ceramic and co-precipitation routes were studied. It was stated that there is the strong dependence of the phase composition and morphology of products on the preparation route. Display Omitted - Highlights: • Zr and Hf germanates were synthesized by ceramic and co-precipitation routes. • The morphology of products depends on the synthesis parameters. • Zirconium germanates forms a set of solid solutions. • Hafnium germanates are stoichiometric compounds

Reducing barriers to energy efficiency in the German mechanical engineering sector. Executive summary

Energy Technology Data Exchange (ETDEWEB)

Schleich, J.; Boede, U.

2000-12-01

This report describes the empirical research into barriers to energy efficiency in the German mechanical engineering (ME) sector. It is one of nine such reports in the BARRIERS project. The report contains description and analysis of four case studies of energy management in German companies in the ME sector. The results are analysed using the theoretical framework developed for the BARRIERS project. The report also provides brief recommendations on how these barriers to the rational use of energy (RUE) may be overcome and how energy efficiency within the ME sector may be improved. The results of the study for the ME sector in Germany are summarised in this executive summary under the following headings: - Characterising the mechanical engineering sector; - Case studies of energy management in the German mechanical engineering sector; - Evidence of barriers in the German mechanical engineering sector; - The role of energy service companies in the mechanical engineering sector; - Policy implications. (orig.)

Reducing barriers to energy efficiency in the German higher education sector. Final report

Energy Technology Data Exchange (ETDEWEB)

Schleich, J.; Boede, U.

2000-12-01

This report describes the empirical research into barriers to energy efficiency in the German higher education (HE) sector. It is one of nine such reports in the BARRIERS project. The report contains description and analysis of six case studies of energy management in German universities. The results are analysed using the theoretical framework developed for the BARRIERS project (Sorrell et al., 2000). The report also provides brief recommendations on how these barriers to the rational use of energy (RUE) may be overcome and how energy efficiency within the sector may be improved. The results of the study for the higher education sector in Germany are summarised in this executive summary under the following headings: - Characterising the higher education sector; - Case studies of energy management in the German higher education sector; - Evidence of barriers in the German higher education sector; - The role of energy service companies in the higher education sector; - Policy implications. (orig.)

Reducing barriers to energy efficiency in the German higher education sector. Executive summary

Energy Technology Data Exchange (ETDEWEB)

Schleich, J.; Boede, U.

2000-12-01

This report describes the empirical research into barriers to energy efficiency in the German higher education (HE) sector. It is one of nine such reports in the BARRIERS project. The report contains description and analysis of six case studies of energy management in German universities. The results are analysed using the theoretical framework developed for the BARRIERS project (Sorrell et al., 2000). The report also provides brief recommendations on how these barriers to the rational use of energy (RUE) may be overcome and how energy efficiency within the sector may be improved. The results of the study for the higher education sector in Germany are summarised in this executive summary under the following headings: - Characterising the higher education sector; - Case studies of energy management in the German higher education sector; - Evidence of barriers in the German higher education sector; - The role of energy service companies in the higher education sector; - Policy implications. (orig.)

Reducing barriers to energy efficiency in the German mechanical engineering sector. Final report

Energy Technology Data Exchange (ETDEWEB)

Schleich, J.; Boede, U.

2000-12-01

This report describes the empirical research into barriers to energy efficiency in the German mechanical engineering (ME) sector. It is one of nine such reports in the BARRIERS project. The report contains description and analysis of four case studies of energy management in German companies in the ME sector. The results are analysed using the theoretical framework developed for the BARRIERS project. The report also provides brief recommendations on how these barriers to the rational use of energy (RUE) may be overcome and how energy efficiency within the ME sector may be improved. The results of the study for the ME sector in Germany are summarised in this executive summary under the following headings: - Characterising the mechanical engineering sector; - Case studies of energy management in the German mechanical engineering sector; - Evidence of barriers in the German mechanical engineering sector; - The role of energy service companies in the mechanical engineering sector; - Policy implications. (orig.)

German concept and status of the disposal of spent fuel elements from German research reactors

International Nuclear Information System (INIS)

Komorowski, K.; Storch, S.; Thamm, G.

1995-01-01

Eight research reactors with a power ≥ 100 kW are currently being operated in the Federal Republic of Germany. These comprise three TRIGA-type reactors (power 100 kW to 250 kW), four swimming-pool reactors (power 1 MW to 10 MW) and one DIDO type reactor (power 23 MW). The German research reactors are used for neutron scattering for basic research in the field of solid state research, neutron metrology, for the fabrication of isotopes and for neutron activation analysis for medicine and biology, for investigating the influence of radiation on materials and for nuclear fuel behavior. It will be vital to continue current investigations in the future. Further operation of the German research reactors is therefore indispensable. Safe, regular disposal of the irradiated fuel elements arising now and in future operation is of primary importance. Furthermore, there are several plants with considerable quantities of spent fuel, the safe disposal of which is a matter of urgency. These include above all the VKTA facilities in Rossendorf and also the TRIGA reactors, where disposal will only be necessary upon decommissioning. The present paper report is concerned with the disposal of fuel from the German research reactors. It briefly deals with the situation in the USA since the end of 1988, describes interim solutions for current disposal requirements and then mainly concentrates on the German disposal concept currently being prepared. This concept initially envisages the long-term (25--50 years) dry interim storage of fuel elements in special containers in a central German interim store with subsequent direct final disposal without reprocessing of the irradiated fuel

German standard and German X-ray guide lines as a guide for quality assurance in X-ray diagnosis

International Nuclear Information System (INIS)

Pychlau, P.

1985-01-01

The German standard DIN 6868 (in preparation) and parts of the German X-ray Ordinance of 1973 deal with quality assurance in X-ray diagnosis. It is shown that both documents support each other and are a guidance for daily work. (author)

[Registries as a tool for optimizing safety of endoprostheses. Experiences from other countries and the setup of the German arthroplasty register].

Science.gov (United States)

Hassenpflug, Joachim; Liebs, Thoralf R

2014-12-01

There has previously been no structured long-term documentation of the results of hip and knee prosthesis operations in Germany. This article presents the objectives, structure and data flow of the newly established German arthroplasty registry (EPRD). The EPRD is run as a subdivision of the German Society for Orthopedics and Orthopedic Surgery (Deutsche Gesellschaft für Orthopädie und orthopädische Chirurgie, DGOOC). It is dedicated to scientific principles and guarantees independency and immediate feedback to surgeons. The cooperation between insurance funds, hospitals, industry and scientific society is the key to success. Additional data acquisition and bureaucratic formalities are limited to a minimum and in particular there is no use of paper. Involving the health insurance funds provides access to relevant routine data. The implant documentation is facilitated by means of an implant library and barcode scanning in the operating room. The EPRD documents the survival of implants including the reasons for revision. Although the highest level of patient data protection is guaranteed, individual patients can be identified in case of implant recalls.

["Maintaining a Common Culture"--the German Research Foundation and the Austrian-German scientific aid in the interbellum].

Science.gov (United States)

Fengler, Silke; Luxbacher, Günther

2011-12-01

After the end of the Great War, private as well as public research funding in Austria was anaemic and slow to develop. Whereas the German state-funded Deutsche Forschungsgemeinschaft (DFG) was established as early as 1920, first steps in that direction were only taken in Austria in the late 1920s. In 1929, the Osterreichisch-deutsche Wissenschaftshilfe (ODW) was founded under the auspices of the Austrian Academy of Sciences and the DFG. Although prima facie on an equal footing, the new research funding organisation was in fact highly dependent on its German cooperation partner. The article explores for the first time ODW's position within the German and Austrian science and foreign policies, which aimed to promote the idea of unification of both states within the German Reich. A quantitative analysis of the subsidies policy in the first five years of existence shows that the ODW gave financial aid primarily to conservative research fields, affecting the intellectual balance of power in the First Austrian Republic. Policy continuities and discontinuities of the organisation in the course of the national-socialist rise to power in Germany after 1933 are examined in the second part of the article. The article thus both increases our knowledge about the most important German research funding organisation DFG, and identifies some of the fundamental structural features of Austrian science policy in the interwar years.

Crossing the Lexicon: Anglicisms in the German Hip Hop Community

Science.gov (United States)

Garley, Matthew E.

2012-01-01

The influence of English on German has been an ongoing subject of intense popular and academic interest in the German sphere. In order to better understand this language contact situation, this research project investigates anglicisms--instances of English language material in a German language context--in the German hip hop community, where the…

Verb Movement Variation in Germanic and Optimality Theory

DEFF Research Database (Denmark)

Vikner, Sten

2001-01-01

This habilitation dissertation falls into two parts. In the first part, "Establishing the typology: Verb Movement in the Germanic VO- and OV-languages", I continue the work in Vikner (1995a, 1997) on the movement of finite verbs across the Germanic languages. Chapter 1 argues that rich finite inf...... data are treated: constructions with auxiliaries, negation and/or do-insertion, and chapter 7 accounts for the differences in distribution between the V2 word order and the non-V2 word order between the languages.......This habilitation dissertation falls into two parts. In the first part, "Establishing the typology: Verb Movement in the Germanic VO- and OV-languages", I continue the work in Vikner (1995a, 1997) on the movement of finite verbs across the Germanic languages. Chapter 1 argues that rich finite...... inflection triggers V°-to-I° movement in the Germanic (and Romance) VO-languages, chapter 2 supports the claim that Yiddish is an OV-language, and chapter 3 defends the view that all Germanic OV-languages except Yiddish do not have V°-to-I° movement. Where Part I tries to establish facts and arguments which...

Surgical strategies in polytraumatized patients with femoral shaft fractures - comparing a German and an Australian level I trauma centre.

Science.gov (United States)

Andruszkow, Hagen; Dowrick, Adam S; Frink, Michael; Zeckey, Christian; Krettek, Christian; Hildebrand, Frank; Edwards, Elton R; Mommsen, Philipp

2013-08-01

Femoral shaft fractures are one of the most common injuries in multiple trauma patients. Due to their prognostic relevance, there is an ongoing controversial discussion as to the optimal treatment strategy in terms of Damage Control Orthopaedics (DCO) and Early Total Care (ETC). We aimed to describe the differences in fracture management and clinical outcome of multiple trauma patients with concomitant femoral shaft fractures treated at a German and an Australian level I trauma centre using the same inclusion criteria. Polytraumatized patients (ISS ≥ 16) with a femoral shaft fracture aged ≥ 16 years treated at a German and an Australian trauma centre between 2003 and 2007 were included. According to ETC and DCO management principles, we evaluated demographic parameters as well as posttraumatic complications and clinical outcome. Seventy-three patients were treated at the German and 134 patients at the Australian trauma centre. DCO was performed in case of increased injury severity in both hospitals. Prolonged mechanical ventilation time, and length of ICU and hospital stay were demonstrated in DCO treatment regardless of the trauma centre. No differences concerning posttraumatic complications and survival were found between both centres. Survival of patients after DCO was similar to those managed using ETC despite a greater severity of injury and lower probability of survival. There was no difference in the incidence of ARDS. DCO was, however, associated with a greatly increased length of time on mechanical ventilation and length of stay in the ICU. We found no differences concerning patient demographics or clinical outcomes in terms of incidence of ARDS, MODS, or mortality. As such, we propose that comparability between German and Australian trauma populations is justified. Despite a higher ISS in the DCO group, there were no differences in posttraumatic complications and survival depending on ETC or DCO treatment. Further research is required to confirm

Organization of the German nuclear industry

International Nuclear Information System (INIS)

Anon.

1992-01-01

Corporate ownership within the German nuclear industry has evolved constantly during the last decade, and recent acquisitions and mergers, reunification of the country, as well as preparation for a unified European power market, have led to many significant changes during the past two years. The country's nuclear industry continues to struggle under an increasingly anti-nuclear political environment, yet nuclear power provided more than one-third of Germany's total electricity generation in 1991. As in many countries, particularly in western Europe, many German companies involved in different facets of the nuclear industry are interrelated. Usually as a means of horizontal or vertical integration, the country's nuclear utilities own, directly or indirectly, shares in uranium mining projects; conversion, enrichment, and fabrication companies; or other utilities' nuclear power plants. The utilities own partial interests in companies in supporting industries as well, including transportation firms, waste management companies, uranium broker/traders, and nuclear equipment manufacturers. While the majority of the companies owned are German, numerous investments are made in non-German firms also

Albrecht Scholz (1940-2013): German dermatologist and historian of dermatology.

Science.gov (United States)

Grzybowski, Andrzej; Parish, Lawrence Charles; Plewig, Gerd

2014-01-01

Albrecht Scholz (Figure 1) was born in Görlitz (now Zgorzelec, a city located at the Polish-German border, covering both sides of the River Nysa) on September 6, 1940, the youngest of three children. His father was a laryngologist, specializing in voice and hearing impairment. Scholz attended school in his hometown and in 1958 passed his Matura examination, after which he studied medicine at both Humboldt University in Berlin and the “Carl Gustav Carus” Medical Academy in Dresden. Following successful completion of the state examination in 1964 and an internship at the Reichenbach Hospital the following year, he was granted the right to practice medicine. His 1964 doctoral dissertation was titled, “Evaluation of Astrand's Steps in Elderly Patients.”

[German neurology and neurologists during the Third Reich: Preconditions and general framework before and after 1933].

Science.gov (United States)

Martin, M; Karenberg, A; Fangerau, H

2016-08-01

This article focuses on the institutional development of neurology in Germany up to the rise to power of the National Socialists and the radical sociopolitical changes after 1933. A wide range of scattered secondary literature was assessed and evaluated. Additionally, some original sources are literally quoted and interpreted according to the context. Since the end of the nineteenth century a complicated process of separation from internal medicine and psychiatry led to the formation of a self-conscious discipline of neurology. The first generation of German neurologists succeeded in founding the German Journal for Neurology ("Deutsche Zeitschrift für Nervenheilkunde") in 1890 and their own neurological association, the Society of German Neurologists ("Gesellschaft Deutscher Nervenärzte", GDN) in 1907. On an international scale, however, the institutional implementation of neurology with only a small number of chairs and few neurology departments remained more than modest. The ambitions for autonomy ended 2 years after the change of power in 1933. Regulatory interventions by the government and psychiatric interests led to the fusion of the GDN with the psychiatric specialist society, the new association being called the Society of German Neurologists and Psychiatrists ("Gesellschaft Deutscher Neurologen und Psychiater", GDNP) in 1935. In this group psychiatrists dominated the discourse. The expulsion, imprisonment and murder of physicians declared as non-Aryan or Jewish along with the forced consolidation ("Gleichschaltung") at the universities prompted profound changes in medical and academic life. It remains an ongoing challenge of neurological historical research to measure the impact of this upheaval on the few neurology departments in hospitals and private practices.

Customer-friendly Approach or Pidginization of German Tourist Discourse

Directory of Open Access Journals (Sweden)

Brigita Bosnar-Valkovic

2012-02-01

Full Text Available If the sentences or phrases like Fast Food-Konzept in Chile, Leonardo goes Gastronomie, Der Claim „Inspiration for modern living“, WM-Countdown läuft; Deutschland ist die fünftgrößte Incoming-Destination weltweit und … are considered, the first impression is that this is a typical mixture of both English and German. To all intents and purposes, they support the main part of a definition of pidgin language. Communication plays a central role in tourism. As emphasized by numerous authors, it is a personification of tourism; conversely tourism could be said to totally encompass a system of communication. As it is a crucial component of the industry, tourist discourse not only serves as a medium for buying/selling tourist products, it also assumes the role of the product itself within the complexity of various economic, technological and political processes in tourism. If analyzed within linguistic norms, discussion of Anglo-American influence on the German tourist discourse should focus on the problem of erosion of the national language, due to the impact of these Ango-Americanisms. The German tourist discourse aims at a customer-friendly approach in order to attract potential buyers or guests, all of which results in a slightly pidginized version of the German tourist discourse.

Inheritance tax-exempt transfer of German businesses: Imperative or unjustified subsidy? An empirical analysis

OpenAIRE

Houben, Henriette; Maiterth, Ralf

2009-01-01

This contribution addresses the substantial tax subsidies for businesses introduced by the German Inheritance Tax Act 2009. Advocates in favour of the vast or even entire tax exemption for businesses stress the potential damage of the inheritance tax on businesses, as those often lack liquid assets to meet tax liability. This submission tackles this issue empirically based on data of the German Inheritance Tax Statistics and the SOEP. The results indicate that former German inheritance tax la...

Cognitive abilities of Emirati and German engineering university students.

Science.gov (United States)

Rindermann, Heiner; Baumeister, Antonia E E; Gröper, Anne

2014-03-01

According to human capital theory, individual competences and personality attributes are relevant for individual productivity and income. Within human capital, intelligence is crucial. To study engineering and work successfully as an engineer, high cognitive abilities are necessary, especially for work in research and development. In a study of 30 German and 30 Emirati engineering students (mean age: 22 years), both groups were tested with mathematical and figural intelligence scales (CogAT). German engineering students achieved a mean IQ of 116, and Emirati students 104 (in converted UK norms). In both groups male students achieved better results than females (2 to 4 IQ point difference). The results are compared with those from PISA and TIMSS. The possible causes of these results, their consequences and strategies for improvement are discussed.

German science and black racism--roots of the Nazi Holocaust.

Science.gov (United States)

Haas, François

2008-02-01

The Nazi's cornerstone precept of "racial hygiene" gave birth to their policy of "racial cleansing" that led to the murders of millions. It was developed by German physicians and scientists in the late 19th century and is rooted in the period's Social Darwinism that placed blacks at the bottom of the racial ladder. This program was first manifested in the near-extermination of the African Herero people during the German colonial period. After WWI, the fear among the German populace that occupying African troops and their Afro-German children would lead to "bastardization" of the German people formed a unifying racial principle that the Nazis exploited. They extended this mind-set to a variety of "unworthy" groups, leading to the physician-administered racial Nuremberg laws, the Sterilization laws, the secret sterilization of Afro-Germans, and the German euthanasia program. This culminated in the extermination camps.

[Results of certification audit in Mexican hospitals, a review from 2009 to 2012].

Science.gov (United States)

Galván-García, Ángel Fernando; Vértiz-Ramírez, José de Jesús; Sauceda-Valenzuela, Alma Lucila; Poblano-Verástegui, Ofelia; Ruelas-Barajas, Enrique; Sánchez-Domínguez, Mario Salvador

2018-01-01

To analyze the participation of Mexican hospitals in the certification process (equivalent to accreditation in other countries). Crosssectional study that analyzes results of 136 establishments audited between 2009 and 2012. Standards with an excellent rating (9.0-10.0), approving (6-8.9) and non-approving (0-5.9) were identified. With a multinomial model, the probability of obtaining non-approving, approving and excellent qualification was calculated. The general average score was 7.72, higher in ambulatory surgery centers (9.10), than in general hospitals (7.30) and specialty hospitals (7.99). All public establishments obtained an approval score. Hospitals audited in 2011 had a higher risk of obtaining an approval (RRR= 4.6, p<0.05) and excellent (RRR= 6.6, p<0.05) rating. The scope of the certification process in Mexico has been limited, with greater participation of the private sector. The evaluation certificate applied in 2011 favored the achievement of approval and excellence results. We recommend homologating the entire process with that of the Joint Commission International JCI.

Typological Analysis of the Yakut and German Polysemantic Verbs KEL and KOMMEN

Directory of Open Access Journals (Sweden)

Svetlana Mitrofanovna Prokopieva

2016-11-01

Full Text Available The analysis of language semantics of the polysemantic verbs kel and kommen of the modern Yakut and German languages brings us to the domain of concepts. Interest in typological studies of languages, in particular, in comparative studies of concept structure of polysemantic verbs has increased thanks to cognitive linguistics which is currently the most intensively developing field of linguistics. The direct nominative meaning of the Yakut verb kel and the German kommen reflects the main components of the concept structure that can be assigned to the concept core: object, operation, result. The purpose of this paper is the typological analysis of lexicographic codification of the phenomenon of polysemy in various languages of the Turkic and German language families. The study is of complex character; to reveal universal and specific ethnic-cultural features of compared Yakut and German linguistic units we used the inductive-deductive method, i.e. theoretical conclusions result from the analysis of practical material. Using the component analysis, lexical units were separated into smallest meaningful parts. Distributive method was used to analyze actualization of meanings of the Yakut and German polysemantic verbs ‘kel’ and ‘kommen’ in context. The typological analysis was invoked to reveal ethnic specifics of compared Yakut and German polysemantic verbs. The polysemantic verbs kel and kommen share the following concepts through subject: ‘man’, ‘animal’, ‘time’, ‘artifact’, ‘emotional-physical state’, and ‘abstract notion’. All concepts given above, 15 lexico-semantic variants, 2 grammatical meanings of the polysemantic word kel and 18 meanings of the verb kommen are represented and codified according to all lexicographic rules and requirements in the Great Academic Dictionary of the Yakut Language and the Great German-Russian Dictionary that are an inexhaustible source for further research into comparative and

The importance of regional availability of health care for old age survival - Findings from German reunification

DEFF Research Database (Denmark)

Vogt, Tobias C.; Vaupel, James W

2015-01-01

BACKGROUND: This article investigates the importance of regional health care availability for old age survival. Using German reunification as a natural experiment, we show that spatial variation in health care in East Germany considerably influenced the convergence of East German life expectancy...... toward West German levels. METHOD: We apply cause-deleted life tables and continuous mortality decomposition for the years 1982-2007 to show how reductions in circulatory mortality among the elderly affected the East German catch-up in life expectancy. RESULTS: Improvements in remaining life expectancy...

A 'German world' shared among doctors: a history of the relationship between Japanese and German psychiatry before World War II.

Science.gov (United States)

Hashimoto, Akira

2013-06-01

This article deals with the critical history of German and Japanese psychiatrists who dreamed of a 'German world' that would cross borders. It analyses their discourse, not only by looking at their biographical backgrounds, but also by examining them in a wider context linked to German academic predominance and cultural propaganda before World War II. By focusing on Wilhelm Stieda, Wilhelm Weygandt and Kure Shuzo, the article shows that the positive evaluation of Japanese psychiatry by the two Germans encouraged Kure, who was eager to modernize the treatment of and institutions for the mentally ill in Japan. Their statements on Japanese psychiatry reflect their ideological and historical framework, with reference to national/ethnic identity, academic position, and the relationship between Germany and Japan.

Marking over 50 years of Franco-German understanding

CERN Multimedia

Corinne Pralavorio

2013-01-01

To mark the 50th anniversary of the Elysée Treaty between France and Germany, which established a basis for cooperation between the two countries in order to set the seal on a lasting peace, secondary school pupils came to CERN to research the Franco-German relationship.   Beneath the Microcosm Garden bubble chamber, Robert Jacob describes the BEBC project to secondary school students from the Pays de Gex and their German exchange partners. On 22 January 1963, German Chancellor Konrad Adenauer and French President Charles de Gaulle signed the Elysée Treaty. This treaty of friendship cemented the partnership between the two countries, which had torn each other apart over the course of several devastating wars. Fifty years on, secondary school students from the Pays de Gex and their German exchange partners have been learning about Franco-German friendship. How was the partnership between the two countries built? Who were its architects? These questions brought them to C...

The German Adaptation and Standardization of the Personality Assessment Inventory (PAI).

Science.gov (United States)

Groves, Julia A; Engel, Rolf R

2007-02-01

We developed the German Adaptation of the Personality Assessment Inventory (PAI; Morey, 1991) under careful consideration of current adaptation literature and guidelines. The adaptation process included the translation of the 344 items into German, a back translation into English as well as the testing of the language equivalence using a bilingual sample. We then standardized the final German version of the PAI for the German population. We compared the American and German norm and reliability data. The observed differences in PAI scale means did not exceed 5 T scores. Internal consistency reliability showed a similar pattern in both language versions, although the German alpha coefficients were on average slightly lower than the American ones. Factor structure was similar in both versions. We discuss expectations about the German PAI and possible problems for its practical usefulness for the German-speaking population.

Myocardial perfusion scintigraphy in Germany. Results of the 2005 query and current status

International Nuclear Information System (INIS)

Lindner, O.; Burchert, W.; Bengel, F.M.; Zimmermann, R.; Dahl, J. vom; Schaefer, W.; Buell, U.; Schober, O.; Schwaiger, M.; Kluge, R.; Schaefers, M.

2007-01-01

The working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine (DGN), in cooperation with the working group Nuclear Cardiology of the German Cardiac Society (DGK), decided to conduct a national survey on myocardial perfusion scintigraphy (MPS). Method: a questionnaire to evaluate MPS for the year 2005 was sent. Results: 346 completed questionnaires had been returned (213 private practices, 99 hospitals and 33 university hospitals). MPS of 112 707 patients were reported with 110 747 stress and 95 878 rest studies. The majority (> 75%) was performed with 99m Tc-MIBI or tetrofosmin. 201 Tl stress-redistribution was used in 22 637 patients (20%). The types of stress were exercise in 78%, vasodilation with adenosine or dipyridamol in 21% and dobutamine in 1%. 99.97% of all MPS were SPECT studies. Gated SPECT was performed in 36% of the stress and in 32% of the rest studies. An attenuation correction was used in 21%. 29 institutions (8%) performed gated SPECT (stress and rest) and attenuation correction. 47% of all MPS were requested by ambulatory care cardiologists, 17% by internists, 12% by primary care physicians, 21% by hospital departments and 2% by others. Conclusion: in Germany, MPS is predominantly performed with 99m Tc-perfusion agents. The common type of stress is ergometry. Gated SPECT and attenuation correction do not yet represent standards of MPS practice in Germany, which indicates some potential of optimization. (orig.)

The German Program and International Education: A Comprehensive Model.

Science.gov (United States)

McConeghy, Patrick M.

1990-01-01

Argues for a comprehensive approach toward teaching German as a second language in response to students' needs to acquire a global perspective. Rather than stressing only syntax, grammar, and vocabulary, German language education should also attempt to teach sensitivity to, knowledge of, and insight into German culture. (JL)

Which Is More Useful in Predicting Hospital Mortality -Dichotomised Blood Test Results or Actual Test Values? A Retrospective Study in Two Hospitals

Science.gov (United States)

Mohammed, Mohammed A.; Rudge, Gavin; Wood, Gordon; Smith, Gary; Nangalia, Vishal; Prytherch, David; Holder, Roger; Briggs, Jim

2012-01-01

Background Routine blood tests are an integral part of clinical medicine and in interpreting blood test results clinicians have two broad options. (1) Dichotomise the blood tests into normal/abnormal or (2) use the actual values and overlook the reference values. We refer to these as the “binary” and the “non-binary” strategy respectively. We investigate which strategy is better at predicting the risk of death in hospital based on seven routinely undertaken blood tests (albumin, creatinine, haemoglobin, potassium, sodium, urea, and white blood cell count) using tree models to implement the two strategies. Methodology A retrospective database study of emergency admissions to an acute hospital during April 2009 to March 2010, involving 10,050 emergency admissions with routine blood tests undertaken within 24 hours of admission. We compared the area under the Receiver Operating Characteristics (ROC) curve for predicting in-hospital mortality using the binary and non-binary strategy. Results The mortality rate was 6.98% (701/10050). The mean predicted risk of death in those who died was significantly (p-value non-binary strategy (risk = 0.222 95%CI: 0.194 to 0.251), representing a risk difference of 28.74 deaths in the deceased patients (n = 701). The binary strategy had a significantly (p-value non-binary strategy (0.853 95% CI: 0.840 to 0.867). Similar results were obtained using data from another hospital. Conclusions Dichotomising routine blood test results is less accurate in predicting in-hospital mortality than using actual test values because it underestimates the risk of death in patients who died. Further research into the use of actual blood test values in clinical decision making is required especially as the infrastructure to implement this potentially promising strategy already exists in most hospitals. PMID:23077528

French pollution and German lignite

International Nuclear Information System (INIS)

Foos, Jacques

2015-01-01

After having recalled that the German energy transition is based on a complete shutting down of nuclear power stations to replace them by renewable energy sources on the one hand, and by coal (lignite, i.e. the dirtiest coal) and gas on the other hand to compensate the intermittency of the former ones, this article notices that pollution peaks occurred in France when an eastern of north-eastern wind was blowing, and not in case of western wind. The author then wanders whether this pollution comes from Germany, and more particularly from the releases of lignite-fuelled power stations. Then, the author comments the high level of pollution associated with coal extraction and exploitation in Germany, causing thousands of deaths and resulting in lung diseases or cancers, myocardial infractions. The author then makes a parallel between, on the one hand, the ignorance of this German pollution and, on the other hand, evacuation measures around Fukushima for a radioactivity which the author considers as less dangerous in terms of life expectancy

Coursebook of German: Gender Aspect

OpenAIRE

Aleksandra Valeryevna Filippova

2015-01-01

The present article regards Aspekte 1 coursebook of German as a foreign language in the context of the gender policy initiated at the end of the last century by sociolinguists and by the representatives of the so called feminist criticism of the German language. This policy has been carried out up to date, and, according to many sociological and linguistic research, it is aimed at destructing gender stereotypes in teaching and reference materials. The use of this policy is conditioned by the ...

[Daily routine in orthopedics and traumatology - results of a nationwide survey of residents].

Science.gov (United States)

Merschin, D; Münzberg, M; Stange, R; Schüttrumpf, J P; Perl, M; Mutschler, M

2014-10-01

The subject orthopedics and traumatology suffers by a loss of attractiveness which results in a lack of young blood. The aim of this study of the Youth Forum of the German Society of Orthopedics and Traumatology (DGOU) is to register the working conditions of residents in orthopedics. In the months September and October 2013 we performed a survey on members of the following German societies: German Society of Orthopedics and Traumatology (DGOU), German Society of Traumatology (DGU) and the German Society of Orthopedics and Orthopedic Surgery (DGOOC), (age working time per week is 55 hours. 73 % of all participants do more than 5 emergency services per month. 52 % are more than 3 times on duty for 24 hours. Only 13 % of all residents have well ordered working hours. Normally working time is divided into three parts: one third for bureaucracy, one for operation theatre and the last for other activities (e.g. ward round). 35,6 % do only one surgery per week, 12 % do not perform any surgeries. An annual report is performed only in 45 %. A structured concept of training only exists in 16 % of all hospitals. In addition to clinical work 45 % are involved in scientific projects, mostly in their spare-time. Finally 58 % of all surgeons would still recommend orthopedics and traumatology. In order to maintain orthopedics and traumatology as an attractive it is necessary to implement flexible working time models and to reorganize and improve training-concepts. Georg Thieme Verlag KG Stuttgart · New York.

The impact of the hospital work environment on social support from physicians in breast cancer care.

Science.gov (United States)

Ansmann, Lena; Wirtz, Markus; Kowalski, Christoph; Pfaff, Holger; Visser, Adriaan; Ernstmann, Nicole

2014-09-01

Research on determinants of a good patient-physician interaction mainly disregards systemic factors, such as the work environment in healthcare. This study aims to identify stressors and resources within the work environment of hospital physicians that enable or hinder the physicians' provision of social support to patients. Four data sources on 35 German breast cancer center hospitals were matched: structured hospital quality reports and surveys of 348 physicians, 108 persons in hospital leadership, and 1844 patients. Associations between hospital structures, physicians' social resources as well as job demands and control and patients' perceived support from physicians have been studied in multilevel models. Patients feel better supported by their physicians in hospitals with high social capital, a high percentage of permanently employed physicians, and less physically strained physicians. The results highlight the importance of the work environment for a good patient-physician interaction. They can be used to develop interventions for redesigning the hospital work environment, which in turn may improve physician satisfaction, well-being, and performance and consequently the quality of care. Health policy and hospital management could create conditions conducive to better patient-physician interaction by strengthening the social capital and by increasing job security for physicians. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

German General Staff Officer Education and Current Challenges

National Research Council Canada - National Science Library

Groeters, Thomas

2006-01-01

"German General Staff Officer Education and Current Challenges" examines the institutional education of German General Staff Officers, as experienced by the author, and offers a "Conceptual Competency...

Trends in food consumption and nutrient intake in Germany between 2006 and 2012: results of the German National Nutrition Monitoring (NEMONIT).

Science.gov (United States)

Gose, Maria; Krems, Carolin; Heuer, Thorsten; Hoffmann, Ingrid

2016-04-01

The German National Nutrition Monitoring (NEMONIT) is a longitudinal and nationwide study to assess changes in food consumption and nutrient intake in Germany. A sample of 1840 participants (baseline age: 14-80 years) was drawn from the nationally representative German National Nutrition Survey (NVS) II (2005-2007). The participants have been interviewed by telephone annually since 2008. Food consumption was assessed by two 24-h recalls in the NVS II and the 4 years of NEMONIT (2008-2012/2013), respectively. Energy and nutrient intakes were calculated using the German Nutrient Database 3.02. Diet quality was evaluated using the Healthy Eating Index-NVS (HEI-NVS) II. Time trends were analysed by generalised estimating equation. Consumption of fruit/fruit products and fruit juice/nectar among men and women decreased, whereas consumption of water, soft drinks and coffee/tea increased over the 6-year period. Furthermore, increased consumption of confectionery and animal fats was observed among women. HEI-NVS II did not change since NVS II in both sexes. There were no changes in energy and protein intakes, but carbohydrate intake declined while fat intake increased over time. Regarding micronutrients, a decreasing intake of thiamin, riboflavin and vitamin B6 was observed in both sexes, but intake of Mg, Fe and niacin increased among women over time. In conclusion, food consumption and nutrient intake remained relatively stable between 2005-2007 and 2012/2013 within this German cohort. A few favourable and unfavourable changes were observed. Compared with national dietary guidelines, consumption of food of plant origin remained too low and consumption of meat/meat products remained too high in Germany.

PSA data base, comparison of the German and French approach

International Nuclear Information System (INIS)

Kreuser, A.; Tirira, J.

2001-01-01

The results of probabilistic safety assessments (PSA) of nuclear power plants strongly depend on the reliability data used. This report describes coarsely the general process to generate reliability data for components and resumes the differences between the German and French approaches. As has been shown in former studies which compared international PSA data, PSA data are closely related to the model definitions of the PSA. Therefore single PSA data cannot be compared directly without regard e.g. to the corresponding fault trees. These findings are confirmed by this study. The comparison of German and French methods shows a lot of differences concerning various details of the data generation process. Some differences between single reliability data should be eliminated when taking into account the complete fault tree analysis. But there are some other differences which have a direct impact on the obtained results of a PSA. In view of the all differences between both approaches concerning the definition of data and the data collection process, it is not possible to compare directly German and French PSA data. However, the database differences give no indication on the influence on the PSA results. Therefore, it is a need to perform a common IPSN/GRS assessment on how the different databases impact the PSA results. (orig.)

Time trends in cigarette smoking in two German cohorts--results from EPIC Germany.

Science.gov (United States)

Rohrmann, S; Kroke, A; Boeing, H; Becker, N

2003-08-01

Smoking prevention is less advanced in Germany compared with other European and North American countries, and fewer data exist, especially on the consumption habits at the individual level over time. EPIC Germany, which is part of a European multicentre study on diet and cancer, collected data on individual smoking behaviour and allows for consideration of the changing consumption pattern for both centres and different age groups. Within EPIC 25 546 and 27 548 participants, respectively, were recruited in Heidelberg and Potsdam. Data on smoking habits were collected by means of a computer-guided interview during the baseline examination between 1994 and 1998. For each birth cohort smoking prevalence and mean number of cigarettes smoked per day at different ages were calculated. Additionally, the prevalence of non-filter cigarette smoking was computed. Smoking prevalence in the 1990s was still higher among men (Heidelberg 16.3-32.3%; Potsdam 18.2-29.3%) than among women (Heidelberg 12.8-32.0%; Potsdam 10.4-27.8%). However, the percentage of women smokers was still increasing. Filter cigarettes comprised a growing percentage of the cigarettes smoked, but especially among men differences between both German cohorts can still be seen: depending on age, 10.0-12.7% of men in the Heidelberg cohort smoked non-filter cigarettes, but only 1.1-2.3% in the Potsdam cohort. The quantity smoked was higher in the Heidelberg than in the Potsdam cohort with respect to the mean number of cigarettes smoked per day as well as the pack-years of smoking. In conclusion, smoking habits in the Potsdam and the Heidelberg cohorts did not strongly differ by smoking prevalence. However, they did differ according to the quantity and quality of smoking. These differences, as well as the changes over the last 40 years may contribute to a changing pattern of diseases in different groups of the German population.

[The quality of the German health-care system in an international comparison - a systematic review].

Science.gov (United States)

Lauerer, M; Emmert, M; Schöffski, O

2013-08-01

Studies assessing the quality of the German health-care system in an international comparison come to different results. Therefore, this review aims to investigate how the German health-care system is evaluated in comparison to other health-care systems by reviewing international publications. Results show starting points for ways to improve the German health-care system, to maintain and expand its strengths as well as to derive strategies for solving identified problems. A systematic review searching different databases [library catalogues, WorldCat (including MEDLINE and OAIster-search), German National Library, Google Scholar and others]. Search requests were addressed to English or German language publications for the time period 2000-2010 (an informal search was conducted in October 2011 for an update). Results of the identified studies were aggregated and main statements derived. In total, 13 publications assessing the German health-care system in an international comparison were identified. These comparisons are based on 377 measures. After aggregation, 244 substantially different indicators remained, which were dedicated to 14 categories. It became apparent that the German health-care system can be characterised by a high level of expenses, a well-developed health-care infrastructure as well as a high availability of personal and material resources. Outcome measures demonstrate heterogeneous results. It can be stated that, particularly in this field, there is potential for further improvement. The utilisation of health-care services is high, the access is mostly not regulated and out of pocket payments can pose a barrier for patients. Waiting times are not regarded as a major weakness. Although civic satisfaction seems to be acceptable, a large portion of the citizens calls for elementary modifications. Especially, more patient-centred health-care delivery should be addressed as well as management of information and the adoption of meaningful electronic

Deutsch im Louvre (oder: Deutsch als tote Sprache) (German in the Louvre [or, German as a Dead Language])

Science.gov (United States)

Markwald, Sabine

1976-01-01

Describes a German course for archeologists and art historians, given in the Louvre by the Paris Goethe Institute. Reliance is placed on the students' visual memory, with schematic presentation of pronoun and article declension. This approach sometimes fosters errors and misunderstandings. The verb system is emphasized. (Text is in German.)…

Economic Dynamics of the German Hog-Price Cycle

Directory of Open Access Journals (Sweden)

Ernst Berg

2015-06-01

Full Text Available We investigated the economic dynamics of the German hog-price cycle with an innovative ‘diagnostic’ modeling approach. Hog-price cycles are conventionally modeled stochastically—most recently as randomly-shifting sinusoidal oscillations. Alternatively, we applied Nonlinear Time Series analysis to empirically reconstruct a deterministic, low-dimensional, and nonlinear attractor from observed hog prices. We next formulated a structural (explanatory model of the pork industry to synthesize the empirical hog-price attractor. Model simulations demonstrate that low price-elasticity of demand contributes to aperiodic price cycling – a well know result – and further reveal two other important driving factors: investment irreversibility (caused by high specificity of technology, and liquidity-driven investment behavior of German farmers.

Smoking restrictions and hospitalization for acute coronary events in Germany.

Science.gov (United States)

Sargent, James D; Demidenko, Eugene; Malenka, David J; Li, Zhongze; Gohlke, Helmut; Hanewinkel, Reiner

2012-03-01

To study the effects of smoking restrictions in Germany on coronary syndromes and their associated costs. All German states implemented laws partially restricting smoking in the public and hospitality sectors between August 2007 and July 2008. We conducted a before-and-after study to examine trends for the hospitalization rate for angina pectoris and acute myocardial infarction (AMI) for an insurance cohort of 3,700,384 individuals 30 years and older. Outcome measures were hospitalization rates for coronary syndromes, and hospitalization costs. Mean age of the cohort was 56 years, and two-thirds were female. Some 2.2 and 1.1% persons were hospitalized for angina pectoris and AMI, respectively, during the study period from January 2004 through December 2008. Law implementation was associated with a 13.3% (95% confidence interval 8.2, 18.4) decline in angina pectoris and an 8.6% (5.0, 12.2) decline in AMI after 1 year. Hospitalization costs also decreased significantly for the two conditions-9.6% (2.5, 16.6) for angina pectoris and 20.1% (16.0, 24.2) for AMI at 1 year following law implementation. Assuming the law caused the observed declines, it prevented 1,880 hospitalizations and saved 7.7 million Euros in costs for this cohort during the year following law implementation. Partial smoking restrictions in Germany were followed by reductions in hospitalization for angina pectoris and AMI, declines that continued through 1 year following these laws and resulted in substantial cost savings. Strengthening the laws could further reduce morbidity and costs from acute coronary syndromes in Germany.

DIMA – Annotation guidelines for German intonation

DEFF Research Database (Denmark)

Kügler, Frank; Smolibocki, Bernadett; Arnold, Denis

2015-01-01

This paper presents newly developed guidelines for prosodic annotation of German as a consensus system agreed upon by German intonologists. The DIMA system is rooted in the framework of autosegmental-metrical phonology. One important goal of the consensus is to make exchanging data between groups...

[The balanced scorecard. "Tool or toy" in hospitals].

Science.gov (United States)

Brinkmann, A; Gebhard, F; Isenmann, R; Bothner, U; Mohl, U; Schwilk, B

2003-10-01

The change in hospital funding with diagnosis related groups (DRG), medical advances as well as demographic changes will call for new quantitative and qualitative standards imposed on German hospitals. Increasing costs and competition in the health care sector requires new and innovative strategies for resource management. Today's policy is mainly defined by rationing and intensified workload. The introduction of DRGs will presumably further constrict management perspectives on pure financial aspects. However, to ensure future development, compassionate services and continued existence of hospitals, a balance of seemingly conflicting perspectives, such as finance, customer, process, learning and growth are of utmost importance. Herein doctors and nurses in leading positions should play a key role in changing management practice. For several years the balanced scorecard has been successfully used as a strategic management concept in non-profit organizations, even in the health care sector. This concept complies with the multidimensional purposes of hospitals and focuses on policy deployment. Finally it gives the opportunity to involve all employees in the original development, communication and execution of a balanced scorecard approach.

A Nodal Pricing Analysis of the Future German Electricity Market

International Nuclear Information System (INIS)

Ozdemir, O.; Hers, J.S.; Bartholomew Fisher, E.; Brunekreeft, G.; Hobbs, B.F.

2009-05-01

The electricity market in Germany is likely to undergo several significant structural changes over the years to come. Here one may think of Germany's ambitious renewable agenda, the disputed decommissioning of nuclear facilities, but also unbundling of TSO's as enforced by European regulation. This study is a scenario-based analysis of the impact of different realizations of known investment plans for transmission and generation capacity on the future German power market while accounting for internal congestion. For this analysis the static equilibrium model of the European electricity market COMPETES is deployed, including a 10-node representation of the German highvoltage grid. Results for the multi-node analysis indicate that price divergence and congestion are likely to arise in the German market as renewable additions affecting mainly the North of Germany, the debated decommissioning of nuclear facilities in the South, and the expected decommissioning of coal-fired facilities in Western Germany appear to render current investment plans for transmission capacity insufficient. The current system of singlezone pricing for the German market may therewith be compromised. However, transmission additions would not benefit all market parties, with producers in exporting regions and consumers in importing regions being the main beneficiaries. Vertical unbundling of German power companies could increase the incentive for constructing transmission lines if generation capacity would cause Germany to be a net-importing country. In case Germany remains a net-exporting country, the effects of vertical unbundling on cross-border capacity are less clear cut.

Psychiatric care in the German prison system.

Science.gov (United States)

Lehmann, Marc

2012-01-01

The purpose of this paper is to describe the nature of medical care within the German penal system. German prison services provide health care for all inmates, including psychiatric care. The reached level of equivalence of care and ethical problems and resource limitations are discussed and the way of legislation in this field since 2006 reform on federal law is described. The article summarizes basic data on German prison health care for mentally ill inmates. The legislation process and factors of influence are pointed out. A description of how psychiatric care is organized in German prisons follows. It focuses on the actual legal situation including European standards of prison health care and prevention of torture, psychiatric care in German prisons themselves, self harm and addiction. Associated problems such as blood born diseases and tuberculosis are included. The interactions between prison staff and health care personal and ethic aspects are discussed. The legislation process is still going on and there is still a chance to improve psychiatric care. Mental health problems are the major challenge for prison health care. Factors such as special problems of migrants, shortage of professionals and pure statistic data are considered. The paper provides a general overview on psychiatric services in prison and names weak points and strengths of the system.

Social capital in a regional inter-hospital network among trauma centers (trauma network): results of a qualitative study in Germany.

Science.gov (United States)

Loss, Julika; Weigl, Johannes; Ernstberger, Antonio; Nerlich, Michael; Koller, Michael; Curbach, Janina

2018-02-26

As inter-hospital alliances have become increasingly popular in the healthcare sector, it is important to understand the challenges and benefits that the interaction between representatives of different hospitals entail. A prominent example of inter-hospital alliances are certified 'trauma networks', which consist of 5-30 trauma departments in a given region. Trauma networks are designed to improve trauma care by providing a coordinated response to injury, and have developed across the USA and multiple European countries since the 1960s. Their members need to interact regularly, e.g. develop joint protocols for patient transfer, or discuss patient safety. Social capital is a concept focusing on the development and benefits of relations and interactions within a network. The aim of our study was to explore how social capital is generated and used in a regional German trauma network. In this qualitative study, we performed semi-standardized face-to-face interviews with 23 senior trauma surgeons (2013-14). They were the official representatives of 23 out of 26 member hospitals of the Trauma Network Eastern Bavaria. The interviews covered the structure and functioning of the network, climate and reciprocity within the network, the development of social identity, and different resources and benefits derived from the network (e.g. facilitation of interactions, advocacy, work satisfaction). Transcripts were coded using thematic content analysis. According to the interviews, the studied trauma network became a group of surgeons with substantial bonding social capital. The surgeons perceived that the network's culture of interaction was flat, and they identified with the network due to a climate of mutual respect. They felt that the inclusive leadership helped establish a norm of reciprocity. Among the interviewed surgeons, the gain of technical information was seen as less important than the exchange of information on political aspects. The perceived resources derived from

Out of the German parliament into the German Museum?

International Nuclear Information System (INIS)

Lieb, E.

1989-01-01

It is currently discussed whether the German Bundestag can deal with the interdepartmental problems of technology assessment with the Commissions of Inquiry on the one hand and whether it has adequate instruments available with the department-related standing Bundestag committees in order to deal with technology assessment. In its report the Commission of Inquiry for Technology Assessment of the past legislative period came to the conclusion that the US parliamentary advisory model which has been realized with OTA could, of course, not be transferred to the situation of the German Bundestag without hesitation, but that the Bundestag should also have a permanent scientific department staff with a sufficient number of personnel and material. The congress was to offer the possibility to discuss the problems of technology assessment with regard to this up-to-date background with experts and members of parliament of the various commissions of inquiry and commissions of the Bundestag which were summoned in order to judge essential technologies and also to solve the problem of the institutionalization of technology assessment. (orig./DG) [de

No grammatical gender effect on affective ratings: evidence from Italian and German languages.

Science.gov (United States)

Montefinese, Maria; Ambrosini, Ettore; Roivainen, Eka

2018-06-06

In this study, we tested the linguistic relativity hypothesis by studying the effect of grammatical gender (feminine vs. masculine) on affective judgments of conceptual representation in Italian and German. In particular, we examined the within- and cross-language grammatical gender effect and its interaction with participants' demographic characteristics (such as, the raters' age and sex) on semantic differential scales (affective ratings of valence, arousal and dominance) in Italian and German speakers. We selected the stimuli and the relative affective measures from Italian and German adaptations of the ANEW (Affective Norms for English Words). Bayesian and frequentist analyses yielded evidence for the absence of within- and cross-languages effects of grammatical gender and sex- and age-dependent interactions. These results suggest that grammatical gender does not affect judgments of affective features of semantic representation in Italian and German speakers, since an overt coding of word grammar is not required. Although further research is recommended to refine the impact of the grammatical gender on properties of semantic representation, these results have implications for any strong view of the linguistic relativity hypothesis.

The Great War and German Memory

DEFF Research Database (Denmark)

Leese, Peter

2012-01-01

Review essay on Jason Crouthamel, The Great War and German Memory. Society, Politics and Psychological Trauma, 1914-18 (2009) and Anton Kaes, Shell Shock Cinema: Weimar Culture and the Wounds of War (2009)......Review essay on Jason Crouthamel, The Great War and German Memory. Society, Politics and Psychological Trauma, 1914-18 (2009) and Anton Kaes, Shell Shock Cinema: Weimar Culture and the Wounds of War (2009)...

Use of Palivizumab in Germany - Report from the German Synagis™ Registry 2009 - 2016.

Science.gov (United States)

Simon, Arne; Gehrmann, Susanne; Wagenpfeil, Gudrun; Wagenpfeil, Stefan

2018-04-16

Following national recommendations, palivizumab is administered in Germany to high-risk infants to prevent hospitalizations related to Respiratory Syncytial Virus infection. In this post marketing observational study (German SYNAGIS™ Registry) data on risk factors and the clinical course of children, who received at least one palivizumab injection between 2009-2016 (01 September to June 30) were entered into an internet-based data entry system by the attending physicians after informed consent. 63 572 immunizations were documented for 12 729 evaluable patients (EVP) from 2009 to 2016, with an average of 5.0 immunizations per patient per season. 45% of infants received more than 5 injections. The predominant primary reason for immunization was premature birth (74%). In the EVP the rate of hospitalizations with causal relationship to RSV was 0.7% (=92/12 729) or 1.2% in a worst case scenario including patients with missing RSV test. In patients with hemodynamically significant congenital heart disease as main indication, RSV-related hospitalization rate was 0.8%. Intensive care was necessary in 16.9% (median duration 3 days), mechanical ventilation in 8.0%. No death related to RSV infection was reported. Keeping in mind the limitations of an uncontrolled prospective observational study, our results confirm the effectiveness and safety of palivizumab prophylaxis. The total number of patients with hsCHD is lower than expected. A better adjustment to the regional epidemiology would probably reduce the need for more than 5 injections. © Georg Thieme Verlag KG Stuttgart · New York.

Attitudes of German Student Teachers on Inclusion

Science.gov (United States)

Baar, Robert

2016-01-01

The contribution discusses attitudes of German Teacher Training Students on Inclusion based on an empirical analysis containing three elements: Evaluation of students' written exams, results of a survey with closed as open questions and the interpretation of group discussions among students about inclusion. One can see that, though the found-out…

[The "best" hospitals in the Netherlands; comments on results from the Elsevier survey].

Science.gov (United States)

van Everdingen, J J

2000-12-30

Health care workers are increasingly asked to disclose the achievements and failures of their medical interventions. Comparative evaluation of hospitals seems to be inevitable. In July 2000 about 6000 health care workers in the Netherlands received a questionnaire from the general lay weekly Elsevier asking them to grade the hospitals in their area: specialists, general practitioners, heads of departments in hospitals, nursing staff and hospital directors. The questionnaire has serious methodological flaws, e.g. regarding the items included (such as 'press sensitivity' and 'waiting lists'), the way in which the score was determined (hospitals that were scored by less than 14 respondents were excluded), the way the questions were formulated (there was no way respondents could indicate their level of experience with the hospitals involved) and the very low response rate (13%). In addition there were no data to determine the accuracy of the questionnaire, the distribution of the respondents, or whether the answers had been adjusted. The questionnaire appears to be primarily aimed at creating sensation. It received little attention in the health care sector, probably because the results were contrary to the expectations. Hospital care will undoubtedly benefit from surveys applying a limited number of well-designed indicators for quality of service, but a questionable public qualification based on a competitive model such as the Elsevier questionnaire will probably do more harm than good.

Risk-oriented analysis of the German prototype fast breeder reactor SNR-300: off-site accident consequence model and results of the study

International Nuclear Information System (INIS)

Bayer, A.; Ehrhardt, J.

1984-01-01

Accident off-site consequence calculations and risk assessments performed for the ''risk oriented analysis'' of the German prototype fast breeder reactor SNR-300 were performed with a modified version of the off-site accident consequence model UFOMOD. The modifications mainly relate to the deposition and resuspension processes, the ingestion model, and the dose factors. Consequence calculations at the site of Kalkar on the Rhine River were performed for 115 weather sequences in 36 wind directions. They were based on seven release categories evaluated for the SNR-300 with two different fueling strategies: plutonium from Magnox reactors only and plutonium from light water reactors and Magnox reactors. In parallel, the corresponding frequencies of occurrence are determined. The following results are generated: 1. complementary cumulative frequency distribution functions for collective fatalities and collective doses 2. expected values of the collective fatalities and collective doses as well as distance-dependent expected values of individual fatality 3. contributions of the different exposure pathways to fatalities with respect to the various organs. For comparison with the risk of a PWR-1300, calculations for the PWR-1300 of the ''German Risk Study'' were repeated with the same modified consequence model. Comparison shows that smaller risks result for the SNR-300. However, the confidence interval bandwidths obtained for the frequencies of the release categories for the SNR-300 are larger than those of the PWR-1300

Assessment of accident risks from german nuclear plants

International Nuclear Information System (INIS)

Heuser, F.W.

1979-01-01

The German risk study are presented. The main objectives can be summed up as follows: (a) An assessment of the societal risk due to accidents in nuclear power plants with reference to German conditions; (b) To get experience in the field of risk analysis and to provide a basis for estimation of uncertainties; (c) To provide guidance for future activities in the German Reactor Safety Research Program. Finally several conclusions reached by this study are discussed. (author)

Results of the Students’ Lecturer Evaluations and Evaluations of Their Own Learning-Outcomes in Accordance with the Bologna Process in German as a Second Foreign Language Program (G2FL

Directory of Open Access Journals (Sweden)

B. Sevinç Mesbah

2013-04-01

Full Text Available Purpose of the Study: While preparing for the Bologna process at our university, student involvement was essential. During the university-wide, end of semester survey, students were asked to evaluate their instructors as well as their individual learning outcomes. Our goal, in the Department of G2FL, was to quantitatively analyze the survey results, the effectiveness of the Department’s language teaching methods and ultimately to ascertain student learning outcomes.Methods: In the first part of the survey, students evaluated their instructors. They answered 15 questions using a five-point scale. In the second part of the survey, they evaluated their own learning outcomes in five language competencies. The data obtained from the students’ evaluation were qualitatively analized by the German Department.Findings: Based on the survey results, the G2FL Department scored higher than the entire university. Most of the students rated themselves good/very good in listening, reading, and writing skills. However, they gave themselves lower marks in the two-way conversation and the oral explanation competencies.Discussions: After the survey, the opinions of 778 students in German Language courseswere evaluated by 12 German Language Lecturers. Finally, the opinions of both studentsand instructors were analyzed by the Department Head.Conclusion: We concluded that our teaching strategy should include a greater emphasis onimproving student conversational competency in German. As such, this year-end surveyidentifies essential learning, concomitantly, the teaching of specific competencies. Once theresults are analyzed in detail, they are very useful for improving the quality of teaching aswell as learning.

Daily time spent indoors in German homes--baseline data for the assessment of indoor exposure of German occupants.

Science.gov (United States)

Brasche, Sabine; Bischof, Wolfgang

2005-01-01

Comprehensive time-activity studies, for use as a basis for estimates of personal exposure, are not readily available in Germany. This analysis of time spent indoors at home is based on data from "Dampness and mould in homes" (2000/ 2001)--a study of about 12,000 persons living in 5530 randomly selected apartments and houses in Germany. The results show the mean times per day people in Germany spend in their homes, classified by gender, age group, building location, city size, region, building type, owner-occupier status, number of people at home, smoking and ventilation habits, moisture emission and ill health factors such as asthma, allergy and number of acute respiratory infections per year. The overall mean time spent at home, 15.7 h per, is in accordance with results from US-American (15.6 h/day) and Canadian (15.8 h/day) human activity surveys carried out in the nineties, as well as being consistent with the German Environmental Survey (1990/92) and a small German study in 1987.

[The practice of special observation in adults in the German-speaking part of Switzerland - a descriptive cross-sectional study].

Science.gov (United States)

Lienhardt, Andrea; Rabenschlag, Franziska; Panfil, Eva-Maria

2018-06-08

The practice of special observation in adults in the German-speaking part of Switzerland - a descriptive cross-sectional study Abstract. Psychiatric Special Observation (PSO) is an intervention often used by nurses to prevent service users of harming themselves or to protect others. The intervention ranges between control and therapy and is resource intensive. Despite the widespread use of PSO, there is still no data on the practice of the intervention in Switzerland. What is the current practice of PSO in adults in psychiatric hospitals in the German-speaking part of Switzerland? Descriptive cross-sectional study. Nurses from inpatient psychiatric services in the German-speaking part of Switzerland completed a questionnaire based on a concept analysis of PSO. 538 questionnaires were analysed. PSO was more often conducted intermittent than as constant observation. In more than one out of four cases, suicidality reasoned as a cause for prescription. Nurses generally used standardized instruments to assess the risk of harming oneself or others. The duration of PSO lasted eight hours or more in three out of four cases. In every fifth case, there was no validation of the need of the intervention taking place during one shift. Nurses have a neutral attitude towards the intervention and are experiencing no or weak negative feelings during performance of PSO. The results suggest that there is an inconsistent performance of PSO in Switzerland as well as in other countries. The validation of the need of the intervention is insufficient. To facilitate PSO as a justified performance, the preparation of an interprofessional guideline is recommended.

Home-made and commercial complementary meals in German infants: results of the DONALD study.

Science.gov (United States)

Hilbig, A; Foterek, K; Kersting, M; Alexy, U

2015-12-01

Infant complementary food can be home-made or bought as ready-to-eat commercial products. The nutrient composition of commercial products is regularised in a European Commission guideline, whereas the preparation of home-made complementary meals is the responsibility of caregivers. In the present study, the composition of commercial and home-made complementary meals as eaten by healthy German infants was compared. Of 8226 complementary meals (74% commercial and 26% home-made) recorded in 1083, 3-day weighed dietary records from 396 participants (6-12 months old) of the German DONALD (DOrtmund Nutritional and Anthropometric Longitudinally Designed) study were analysed. Median energy density (kcal 100 g(-1)) was highest in commercial and home-made cereal-milk meals (89 kcal 100 g(-1)). In home-made savoury and cereal-fruit meals, the energy density was significantly higher compared to their commercial counterparts. Median protein contents were highest in savoury and cereal-milk meals (>2.5 g 100 g(-1)) and dairy-fruit meals (2-4 g 100 g(-1)). Added sugars were found in less than a quarter of meals. Highest median sodium contents were found not only in commercial savoury meals (median 38 mg 100 g(-1)) and vegetable meals (32 mg 100 g(-1)), but also in home-made cereal-milk meals (36 mg 100 g(-1)). Both median fat and iron contents were higher in home-made meals compared to commercial savoury and cereal-fruit meals. With the exception of the higher sodium content in commercial savoury meals for older infants, the lower fat content in commercial savoury and cereal-fruit meals, and the added sugar content in some commercial dairy-fruit meals, a comparison of commercial and home-made complementary meals did not reveal any serious inadequacy. © 2015 The British Dietetic Association Ltd.

Gender differences in depression scores of Iranian and german medical students.

Science.gov (United States)

Ahmadi, Jamshid; Ahmadi, Nahid; Soltani, Fereshteh; Bayat, Fatemeh

2014-01-01

The aim was to evaluate gender differences in depression scores of Iranian and German medical students. Two hundred Iranian medical students (100 men and 100 women) and 200 German medical students (100 men and 100 women) were selected randomly and completed the English form of the self-rating Beck Depression Inventory (BDI). Analysis gave a mean rating of 10.7 ± 6.6 for Iranian men and 10.9 ± 7.81 for Iranian women (NS). Also, 5 ± 4.9 for German men and 5.6 ± 5.0 for German women (NS). On Item 2, which asked whether the person was pessimistic 33% of Iranian men and 30% of Iranian women indicated that they were pessimistic (NS). Also, 21% of German men and 20% of German women indicated that they were pessimistic (NS). On Item 9, which asked about suicidal tendencies, 9% of Iranian men and 13% of Iranian women reported as having suicidal tendencies (NS). Also, 13% of German men and 21% of German women reported as having self-harming thoughts (NS). The present study showed no gender differences in Iranian and German medical students' scores on the BDI.

Self-rated treatment outcomes in medical rehabilitation among German and non-German nationals residing in Germany: an exploratory cross-sectional study.

Science.gov (United States)

Brzoska, P; Sauzet, O; Yilmaz-Aslan, Y; Widera, T; Razum, O

2016-03-28

In many European countries, foreign nationals experience, on average, less favorable treatment outcomes in rehabilitative care than the respective majority population. In Germany, this for example is reflected in a lower occupational performance and a higher risk of disability retirement after rehabilitation as analyses of routine data show. However, little is known about the perspective of health care users. The aim of the present study was to compare self-rated treatment outcomes between German and non-German nationals undergoing in-patient medical rehabilitation in Germany. We analyzed data from a cross-sectional representative rehabilitation patient survey of 239,811 patients from 642 clinics in Germany who completed about 3 weeks of in-patient rehabilitative treatment. The self-rating of the treatment outcome was based on a dichotomized Likert scale consisting of three items. A multilevel logistic regression analysis adjusted for various demographic, socio-economic, health and other covariates was conducted to examine differences in the self-rated treatment outcome between German and non-German nationals. Of the 239,811 respondents 0.9% were nationals from Turkey, 0.8% had a nationality from a former Yugoslavian country, 0.9% held a nationality from the South European countries Portugal, Spain, Italy or Greece and 1.9% were nationals from other countries. Non-German nationals reported a less favorable self-rated outcome than Germans. Adjusted odds ratios [OR] for reporting a less favorable treatment outcome were 1.24 (95%-confidence interval [95%-CI]: 1.12-1.37) for nationals from the South European countries Portugal/Spain/Italy/Greece, 1.62 (95%-CI: 1.45-1.80) for Turkish nationals and 1.68 (95%-CI: 1.52-1.85) for nationals from Former Yugoslavia. Knowledge on health outcomes from the patients' point of view is important for the provision of patient-centered health care. Our study showed that non-German nationals report less favorable outcomes of

Dictionary for veterinary science and biosciences. German-English/English-German. With trilingual appendix: Latin terms. Woerterbuch fuer Veterinaermedizin und Biowissenschaften. Deutsch-Englisch/Englisch-Deutsch. Mit einem dreisprachigen Anhang: Lateinische Begriffe

Energy Technology Data Exchange (ETDEWEB)

Mack, R

1988-01-01

This dictionary has been compiled as a result of many years of experience of translating German texts in the biological sciences, particularly veterinary medicine. The author's aim is to supplement the standard German-English general dictionaries with technical terms in the fields of anatomy, microbiology, physiology, parasitology, pathology, pharmacology, toxicology and zootechnique, with special reference to domestic animals and their diseases.

German and Ukrainian Phonological Isomorphs. Typology: Germanic and Slavic Languages. German-Ukraine-Slavic Contrasting Correspondence Vocabulary

Science.gov (United States)

Petryshyn, Ivan

2016-01-01

The works of many scholars on Germanic and Slavic Languages do not really try to contrast the two biggest Indo-European language families, but analyse them seperately, as any close comparison seem to be unconvincible. In many works, we find some parts that usually would deal with loan words/borrowings/barbarisms. And, yet, we noticed that there…

[Presenteeism, Absenteeism and psychosocial stress at work among German clinicians in surgery].

Science.gov (United States)

Klein, J

2013-10-01

Presenteeism is determined as turning up at work despite ill health. In the last decade this phenomenon became much more relevant and will be a central topic for future research in workplace health, health promotion and productivity loss. Compared to absenteeism research data about presenteeism are comparatively rare. Especially employees in health care are at high risk for presenteeism. The present study examines the degree of presenteeism and absenteeism among German hospital clinicians in surgery focussing on associations with psychosocial stress at work. The stratified randomised sample consisted of 1 311 German clinicians in surgery from 489 hospitals. The frequencies of presenteeism and absenteeism were respectively assessed by one item. Psychosocial stress at work was measured by the effort-reward imbalance model and the demand-control model. About 90% of the respondents indicate that they were working despite illness at least once a year, 65% actually answered sometimes or often. Nearly two thirds were absent due to illness for a minimum of once a year. Multivariate logistic regression analyses show that organisational and work-related factors are clearly associated with presenteeism. Compared to absenteeism, presenteeism shows stronger associations with psychosocial workload. Significant associations with different components of psychosocial stress reveal elevated odds ratios between 1.4 and 2.8. High efforts and demands, low rewards and increased overcommitment were notably emerging factors. Clinicians in surgery are affected by presenteesim to a high degree whereas rates of absenteeism are less striking. As potential causes for elevated presenteeism different aspects of psychosocial stress at work were identified. Workplace health promotion on different levels can reduce presenteeism to improve the health status and job performance among this occupational group that bears heavy responsibility. © Georg Thieme Verlag KG Stuttgart · New York.

Conclusions Drawn from the Investigation of LOCA-Induced Insulation Debris Generation and its Impact on Emergency Core Cooling (ECC) at German NPPs - Approach Taken by / Perspective of The German TSO (TuV)

International Nuclear Information System (INIS)

Huber, J.

2004-01-01

Initiated by the Barsebaeck incident in 1992 and the following activities related to the LOCA-induced insulation debris generation and its impact on emergency core cooling, investigations on German PWRs and BWRs were performed in these areas. The investigations on the German BWRs were carried out in detail immediately after the Barsebaeck incident in the years 1992 through 1994. Detailed investigations on the German PWRs started after the issue of the OECD report in 1996. Therefore the investigations on the impact of LOCA-induced insulation debris generation on strainer plugging carried out in Germany in the last years were focused mainly on the German PWRs. In the framework of these investigations of the German PWRs, the relevant parameters and phenomena were investigated in detail by the plant owners in the years from 1997 through 1999. The results were summarised in reports for each plant. The main results of the investigations conducted by the plant owners were that the plant owners considered backfitting in German PWRs is not necessary to guarantee emergency core cooling following a LOCA with insulation debris generation. As the technical support organisation for the German Bavarian and Hessian state authority, the TUV Suddeutschland was called upon to examine these investigations and the conclusions drawn by the plant owners. We compared each of the parameters and phenomena against the state of knowledge. The results of our examination in 1999 showed that the investigations of the plant owners were generally correct, but we stated also, that due to existing uncertainties, further investigations are necessary to validate the results. To meet these demands, the plant owners installed a working group for planning and performing newer, more realistic large-scale experiments (scaling factor 1:4) to investigate the transport mechanism of the insulation material within the containment sump, the head loss at the strainers and to estimate the amount of insulation

Mid-point review of the German energy transition

International Nuclear Information System (INIS)

Lauer, H.; Safa, H.; Guidez, J.

2017-01-01

The result of the 2015 review of the German energy transition is lukewarm. First: generating 20 % of the electricity production through wind power and solar energy appears to be very costly in Germany. Secondly there is practically no effect on the reduction of CO_2 releases as coal has been re-introduced to play the role of nuclear energy which was carbon-free to counter-balance the intermittency of renewable energies. Thirdly a necessity to keep all thermal plants ready to operate in order to cope with the intermittency of renewable energies as no adequate means of energy storage is available, appears to be a luxury that only Germany can afford. And fourthly, the cost of electric power for households and small enterprises is all the higher as the government economic policy is to spare German electro-intensive industry. One of the side effects of the German energy transition policy is to disturb the European market of electricity when favourable climate conditions make green electricity very abundant. In this situation electricity prices drop sharply and can even become negative while green electricity is always paid to the producer at a steady price guaranteed by the state. (A.C.)

Green Infrastructure and German Landscape Planning: A Comparison of Approaches

Directory of Open Access Journals (Sweden)

Catalina VIEIRA MEJÍA

2015-11-01

Full Text Available A variety of similarities between green infrastructure and the German landscape planning can be found in comparing the approaches of the two planning instruments. Principles of green infrastructure such as multifunctionality, the multi-scale approach and connectivity show correspondences with landscape planning elements. However, some differences are apparent. The objective of this paper is to determine whether the main aims of these two frameworks overlap. It also seeks to deduce what benefits from ecosystem services could be provided by integrating the green infrastructure approach into the German landscape planning system. The results show that the green infrastructure concept is not well-known in German planning practice, although its principles are generally implemented through traditional landscape planning. Nevertheless, green infrastructure could act as a supplementary approach to current landscape planning practices by improving public acceptance and strengthening the social focus of the current landscape planning system.

Managing export success – An empirical picture of German wineries’ performance

Directory of Open Access Journals (Sweden)

Dressler Marc

2015-01-01

Full Text Available Export represents an important strategic lever for enterprises to reach new clients, to diversify, and to participate in regional economic growth. An online based survey invited more than 800 wine experts to assess wine export success factors as well as the performance of German producers. The questionnaire tested a literature based success factor framework with the four success factors. The experts assessed the relevance of the levers for the wine industry and the performance of German produc- ers. Respondents judged all four success factors as well as all underlying 27 criteria to be relevant in the wine industry. Export strategy receives highest value of the success factor rating. The survey depicts a heterogeneous performance of German produc- ers comparing the success factors but a homogeneous performance for all the underlying criteria within each success factor. The responses reveal a performance gap for the success factors export commitment and export strategy. For the success factor export knowledge German producers apparently overperform. Export programs are of importance and in the case of Germany appar- ently meet the needed level of support and activity. The results thereby support empiric findings in the context of cultural differ- ences of different nations. The study provides orientation for German wine producers but also small and medium enterprises of other industries.

'Combating' tropical diseases in the German colonial press.

Science.gov (United States)

Correa, Sílvio Marcus de Souza

2013-03-01

This article shows how much certain German language newspapers were a vehicule for reporting to the lay public on 'combating' tropical diseases. Through the press, immigrants and their descendents in Brazil were informed not only about the diseases which afflicted German colonists in Africa, but also about measures concerning sanitation, prophylaxis and experiments with tropical medicine, etc. Based on hemerographic sources, it shows how successful the overseas German communities were in sharing their experiences regarding health in tropical and/or sub-tropical regions.